Parkinson’s disease

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Central nervous system

Substantia nigra

Paralysis agitans; Shaking palsy

There is no known cure for Parkinson's disease. The goal of treatment is to control symptoms. 

Medications control symptoms primarily by increasing the levels of dopamine in the brain. The type of medication, the dose, the amount of time between doses, or the combination of medications used may need to be adjusted as symptoms change. Many medications can cause severe side effects, so monitoring and follow-up by the health care provider is important.

Types of medication:

• Deprenyl may provide some improvement to mildly affected patients.
• Amantadine or anticholinergic medications may be used to reduce early or mild tremors.
• Levodopa is a medication that the body converts to a brain transmitter called dopamine. It may be used to increase the body's supply of dopamine, which may improve movement and balance.
• Carbidopa is a medication that reduces the side effects of levodopa and makes it work better.
• Entacapone is a medication used to prevent the breakdown of levodopa.
• Pramipexole and ropinirole are dopamine medications used before or together with levodopa.
• Rasagiline is a medicine recently approved for patients with early Parkinson's disease. It may also be combined with levodopa in patients with more advanced cases of the disease. Rasagiline helps block the breakdown of dopamine.

Additional medications to help reduce symptoms or control side effects of primary treatment medications include antihistamines, antidepressants, dopamine agonists, monoamine oxidase inhibitors (MAOIs), and others.

Good general nutrition and health are important. Exercise should continue, with the level of activity adjusted to meet the changing energy levels that may occur. Regular rest periods and avoidance of stress are recommended, because fatigue or stress can make symptoms worse. Physical therapy, speech therapy, and occupational therapy may help promote function and independence.

Railings or banisters placed in commonly used areas of the house may be of great benefit to the person experiencing difficulties with daily living activities. Special eating utensils may also be helpful.