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Saturday, December 3, 2022

Treatments for Parkinson’s disease

By Saline Deutsh

Special to CSMS Magazine

More than one million of Americans have been diagnosed with Parkinson’s disease—the progressive, degenerative brain disorder. An equal number are thought to have the condition—but don’t know it.

One percent of people over 60 have Parkinson’s as do 2% of those over 65. But the condition can strike at any age.

There’s no cure for Parkinson’s. Drugs remain the mainstay of treatment, although surgery has become an option.

The Symptoms

Most people are the first alerted to the possibility that they have Parkinson’s by friends or family members who notice…

  • Tremor. It’s more relaxed. Most Parkinson’s related tremors are more pronounced on one side of the body.
  • Slow movement (bradykinesia). People with Parkinson’s swing their arms less when walking and take longer to wash dishes, take out the garbage, etc.
  • Rigidity. Muscles become stiff and resistant to movement.
  • Poor balance. Because they have trouble telling when they’re standing straight, people with Parkinson’s are likely to fall.

What Causes Parkinson’s disease?

Parkinson’s disease stems from damage to substantia nigra. The region of the brain that produces the neurotransmitter dopamine, which is vital to the function of a second brain area called the striatum—which controls movement.

            Just what destroys the substania nigra is unclear. Heredity is apparently a factor. Recent studies suggest that pesticides may play a role as well.

            The existence of clusters of Parkinson’s disease—as on the island of Guam—suggest that environmental factors may also be involved. Still, the root cause remains unknown.

            Bottom line: There is no known way to prevent the disease.

The Fastest Treatment

The principal treatment is with a drug called L-dopa (Sinemet).

            L-dopa is quite effective at controlling symptoms of Parkinson’s. But there is a problem—fluctuating levels of the drug within the brain. When levels are low, Parkinson’s symptoms return. High levels can cause tics, spasms and other side effects.

            To maintain the right level, many Parkinson’s patients take time-release L-dopa.

            The drug selegiline (Eldepryl) helps maintain proper dopamine levels by blocking the action of an enzyme that ordinarily breaks dopamine down.

            With or without selegiline, L-dopa works well for just so long. After five to 10 years, most patients have increased side effects and poorer response.

            Doctors now have another drug in their anti-Parkinson’s arsenal—tolcapone (Tasmar), through its usefulness may limit by liver toxicity.

            If you or someone you know is interested in participating in a critical trial of these drugs, contact the National Parkinson Foundation. (800-327-4545, www.parkinson.org)

Note: Saline Deutsh lives and works in Baton Rouge, Louisiana. She wrote this piece exclusively for CSMS Magazine.

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