Medication can help manage problems related to mobility and tremors. Most drugs used to treat Parkinson’s help maintain dopamine levels in the brain, or imitate the action of dopamine in the brain. The main types of medication used to reduce the symptoms of Parkinson’s disease are:
- Carbidopa-levodopa: Levodopa is the most effective Parkinson's disease drug, and helps treat stiffness, mobility problems, and tremors. Levodopa is a natural substance used by nerve cells to create dopamine. Carbidopa (Lodosyn) is added to levodopa to reduce or eliminate adverse effects like nausea. As Parkinson’s disease progresses over time, the benefits of levodopa begin to wear off. Additionally, larger doses of levodopa may cause uncontrollable movements (dyskinesia). To control these side effects, your doctor may reduce your dose or change the timing of your doses.
- Dopamine agonists: Dopamine agonists mimic the action of dopamine in the brain. These drugs aren't as effective as levodopa but do last longer. They may be prescribed along with levodopa to manage the effects of levodopa usage. Pramipexole (Mirapex), ropinirole (Requip), and rotigotine (Neupro, given as a patch) are all dopamine agonists. Apomorphine (Apokyn) is a short-acting injectable dopamine agonist that is used to provide relief quickly.
- MAO B inhibitors: These drugs help block the brain enzyme monoamine oxidase B (MAO B), which breaks down dopamine in the brain. By blocking the MAO B enzyme, these drugs allow dopamine’s effects to last longer in the brain. Common MAO B inhibitors include Selegiline (Zelapar), rasagiline (Azilect), and safinamide (Xadago).
- Catechol O-methyltransferase (COMT) inhibitors: Like MAO B inhibitors, these drugs block an enzyme that breaks down dopamine in the brain. This helps prolong the effects of levodopa treatment. Entacapone (Comtan) and opicapone (Ongentys) are the most common COMT inhibitors.
- Amantadine: Amantadine helps relieve involuntary movement associated with early-stage Parkinson's disease.
