Medications can provide dramatic relief from Parkinson's symptoms, but no drug can stop the progression of the disease. In some cases, surgery is an option. Some doctors recommend physical therapy or muscle strengthening. For many patients, a combination of these approaches works best.
Levodopa, combined with another drug called carbidopa or Sinemet, is the mainstay of Parkinson's therapy. Levodopa is rapidly converted into dopamine by the enzyme dopa decarboxylase (DDC), which is present in the central and peripheral nervous systems. Much of levodopa is metabolized before it reaches the brain.
Because these drugs are known to cause side effects and can become ineffective after prolonged periods of use, other drugs, such as dopamine agonists, amantadine, COMT inhibitors and anticholinergic medications also are used to treat Parkinson's disease.
When medication is ineffective, surgery may be an option to control symptoms and improve quality of life. However, not everyone is a good candidate for surgery. For example, if a patient never responded or no longer responds to levodopa and carbidopa, surgery is unlikely to help. Only about 10 percent of Parkinson's patients are candidates for surgery.
Three surgical procedures are performed to treat Parkinson's disease — ablative or destructive surgery, stimulation surgery or deep brain stimulation (DBS), and transplantation or restorative surgery.
Complementary or integrative care combines the best of alternative therapies — such as acupuncture, massage, meditation, herbs and nutrition — and conventional medicine. A number of treatments such as simply physical activity, physical therapy, massage and support groups can help relieve symptoms and improve quality of life. Discuss with your doctor the possible treatments he or she recommends to treat your symptoms.
Reviewed by health care specialists at UCSF Medical Center.