Parkinson's Disease

Currently there is no permanent cure available for PD. The aim of the treatment therefore is to help the patient maintain the quality of his life by minimizing disability and controlling the side effects of the drugs.Optimal treatment is individualized and is best left to the discretion of the doctor who is treating the patient.

Physiotherapy helps to reduce rigidity and correct abnormal posture. Speech therapy is given to improve speech.

The following are the indications for the treatment of Parkinson’s Disease:

» Prevention of disease progression

» Symptomatic control of Parkinsonism

» Prevention of motor complications

» Control of motor complications

» Control of non-motor complications

1.Drug treatment

The purpose of drug therapy is to relieve symptoms and improve the quality of life . Drugs do not help to stop the progression of the disease . Drugs help the affected individual to function better but may cause side effects . The patient may be required to take medications several times a day. These drugs work on the brain’s complex chemistry and must be used only as prescribed. The dosages of these drugs must never be altered without first consulting the doctor .

After three to six years of drug treatment, many patients begin to lose sustained benefits. The result is increasing time spent ‘off ’or without relief from symptoms. Increasing the amount of medication can usually minimize ‘off’ time to acceptable levels for several years. After three to six years, patients often also develop uncontrolled movements called ‘dyskinesias’ that occur when their drug treatment is working. For patients on levodopa, a COMT inhibitor such as tolcapone and entacapone may be added to help increase the effectiveness of levodopa. . A combination pill has been specially developed that contains levodopa and entacapone . In addition, an injectable medication such as apomorphine may be used as a rescue therapy, to facilitate a rapid return to the ‘ on’ state.

Some of the common drugs used in the treatment of Parkinson’s Disease are:

Levodopa , Amantadine, Anticholinergics , MAO-B inhibitors , COMT inhibitors , DA agonists

Ergot compounds Bromocriptine , Cabergoline , Lisuride, Pergolide

Non-Ergot Compounds: Apomorphine, Piripedil , Pramipexole , Ropinirole

2. Surgical Treatment

Surgical cure is sometimes advocated in severe cases.