Medication

Medications for Parkinson’s

There is not yet a cure for Parkinson’s disease, but symptoms can be treated with medication.

Should I start treating my symptoms with medication now or should I wait a while? Which medications are right for me? These are among the tough questions people with Parkinson’s disease are faced with. Your answers will be balanced among many other considerations.

Before making any decisions about treatment of Parkinson’s disease, you will want to learn about the different types of medications available for Parkinson’s disease and discuss the pros and cons of each with your physician. It may help to know that there is no “right” answer, and if you try something that doesn’t work for you, you can always adjust your plan.

Levodopa: the most effective drug for treating Parkinson’s

Levodopa, also known as L-DOPA, has long been, and continues to be, the most effective drug in treating Parkinson’s disease symptoms in people of all ages, and most will take the drug at some point. However, there are side effects associated with Levodopa. Research suggests that younger people on medications like levodopa are more likely than older people to develop motor fluctuations and involuntary movements (most commonly called dyskinesia). Therefore, some younger people choose to delay the use of L-DOPA, opting instead for treatment with dopamine agonists, especially in the early stages of the disease.

Full List of Medications Approved for the Treatment of Parkinson’s Disease in the USA

Below is a full list of Parkinson’s medications that have been approved to treat Parkinson’s in the United States, as of July 2012. This material is intended to provide you with information. It should not be used for treatment purposes, but rather as a source for discussion with the patient’s own physician. Work with your physician to determine which medications are best for you, and know the risks and benefits of each.

Click here to access the .PDF to print out and discuss with your doctor.

 

Generic NameTrade NameMode of ActionCommon Side Effects*
Carbidopa-levodopaSinemetDOPA decarboxylase inhibitor/DA precursorNausea, vomiting, dizziness, low blood pressure, anxiety, dyskinesia, confusion, hallucinations
Carbidopa-levodopa (controlled release)Sinemet CRDOPA decarboxylase inhibitor/DA precursorNausea, vomiting, dizziness, low blood pressure, anxiety, dyskinesia, confusion, hallucinations
Carbidopa-levodopa (orally disintegrating tablet)ParcopaDOPA decarboxylase inhibitor/DA precursorNausea, vomiting, dizziness, low blood pressure, anxiety, dyskinesia, confusion, hallucinations
Carbidopa-levodopa (extended release capsultesRytaryDOPA decarboxylase inhibitor/DA precursorNausea, dizziness, headache, sleeplessness, dyskinesia, confusion, hallucinations, constipation, vomiting, low blood pressure.
Carbidopa-levodopa-entacapone< (enteral suspension)/span>DuopaDOPA decarboxylase inhibitor/DA precursorSwelling of legs and feet, nausea, dizziness, dyskinesia, confusion, hallucinations, high blood pressure, mouth or throat pain.
Carbidopa-levodopa-entacaponeStalevoDOPA decarboxylase inhibitor/DA precursor/COMT inhibitorDarkened saliva and/or body fluids, diarrhea, fatigue, dizziness, abdominal pain, dyskinesia, pain, constipation, hallucinations
PramipexoleMirapexDA agonistNausea, dizziness, low blood pressure, swelling of ankles, dyskinesia, hallucinations, confusion, somnolence, sleep attacks
Pramipexole (extended release)Mirapex ERDA agonistNausea, dizziness, low blood pressure, swelling of ankles, dyskinesia, hallucinations, confusion, somnolence, sleep attacks
RopiniroleRequipDA agonistNausea, dizziness, low blood pressure, swelling of ankles, dyskinesia, hallucinations, confusion, somnolence, sleep attacks
Ropinirole (extended release tablets)Requip XLDA agonistNausea, dizziness, low blood pressure, swelling of ankles, dyskinesia, hallucinations, confusion, somnolence, sleep attacks
Apomorphine (injection)ApokynDA agonistNausea, vomiting, dizziness, low blood pressure, sedation, yawning, hallucinations, dyskinesia, runny nose, swelling of extremities, injection site reactions
Rotigotine (transdermal patch)NeuproDA agonistSkin reactions at the patch site, dizziness, nausea, vomiting, drowsiness, insomnia, sleep attacks, hallucinations, low blood pressure
SelegilineEldeprylMAO-B inhibitor; inhibits dopamine metabolismInsomnia, gastrointestinal upset, dyskinesia, hallucinations, confusion
Selegiline (orally disintegrating tablet)Zelapar, CarbexMAO-B inhibitor; inhibits dopamine metabolismDizziness, nausea, pain, headache, insomnia, runny nose, dyskinesia
RasagilineAzilectMAO-B inhibitor; inhibits dopamine metabolismGastrointestinal upset, headache, dyskinesia
TolcaponeTasmarCOMT inhibitor; decreases levodopa metabolismDyskinesia, nausea, dizziness, diarrhea, hallucinations, urine discoloration, elevated liver function enzymes
EntacaponeComtanCOMT inhibitor; decreases levodopa metabolismSame as Tasmar, except it does not commonly elevate liver function enzymes
AmantadineSymmetrelDA re-uptake inhibitor; stimulates DA receptors; anticholinergic, NMDA antagonistHallucinations, leg swelling, dizziness, mottled leg skin (livedo reticularis), insomnia, confusion, dry mouth and eyes, constipation
TrihexyphenidylArtaneAnticholinergicDry mouth & eyes, constipation, urinary retention, memory impairment, confusion, depression, hallucinations
BenztropineCogentinAnticholinergicDry mouth & eyes, constipation, urinary retention, memory impairment, confusion, depression, hallucinations

COMT = Cathechol-o-methyltransferase
DA = Dopamine
DOPA = Dopamine
MAO = Monoamino oxidase
NMDA = N-methyl-D-aspartate

* The most common side effects are listed. Additional side effects should be discussed with your healthcare provider.

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