None " normal" Parkinson drugs improve my condition. Tests done- Datscan, IBZM… resulted in the diagnosis of : none-typical Parkinson, that does not respond to L-Dopa or L-Dopa agonists.
A variety of medications can provide dramatic relief from Parkinson's disease symptoms. However, any medications that are used to treat this condition lose their benefit or begin to cause intolerable side effects over time. Also, no medication is available that can stop or slow down the progression of the disease.
Parkinson's disease medications can be separated into different classes based on the way they work. These different classes of Parkinson's drugs include: Levodopa; Dopamine agonists; Monoamine oxidase inhibitors (MAOIs); Anticholinergics; Other miscellaneous medications.
First introduced in the 1960s, levodopa delays the onset of debilitating symptoms and allows the majority of people with Parkinson's disease -- who would otherwise be quite disabled -- to extend the period of time in which they can lead relatively normal, productive lives.
For Parkinson's disease treatment, people are usually given levodopa combined with carbidopa (Sinemet®, Sinemet® CR, or Parcopa®). When added to levodopa, carbidopa delays the conversion of levodopa into dopamine until it reaches the brain, thereby preventing or diminishing some of the side effects that often accompany levodopa therapy. Carbidopa also reduces the amount of levodopa needed.
Although levodopa helps at least three-quarters of people with the disease, not all symptoms respond equally to this Parkinson's disease drug. Bradykinesia (slow movement) and rigidity respond best to this medication, while tremors may be only marginally reduced. Problems with balance and other symptoms may not improve at all.
Also, people who have taken other Parkinson's medications before starting levodopa therapy may have to cut back or eliminate these drugs in order to experience the full benefit of levodopa. Once levodopa therapy starts, people often respond dramatically. However, people taking levodopa may need to gradually increase the dose for maximum benefit.
Because a high-protein diet can interfere with the absorption of levodopa, some healthcare providers recommend that people who are taking the drug only consume protein during their evening meal.
Levodopa is so effective that some people may forget they have Parkinson's. But levodopa is not a cure. Although it can diminish the symptoms of Parkinson's disease, it does not replace lost nerve cells, and it does not stop the progression of the disease.
Dopamine agonist drugs for Parkinson's disease to deal with particular symptoms or stages of the disease. Examples of dopamine agonists approved for treating Parkinson's disease include: Apomorphine (Apokyn); Bromocriptine (Parlodel); Pergolide (Permax); Pramipexole (Mirapex) or pramipexole ER (Mirapex ER); Ropinirole (Requip).
These five drugs mimic the role of dopamine in the brain, causing the neurons to react as they would to dopamine.
Dopamine agonists can be given alone or with levodopa, and may be used in the early stages of the disease or started later to lengthen the duration of response to levodopa in people experiencing wearing off or on-off effects. These different medications are generally less effective than levodopa in controlling rigidity and bradykinesia.
Monoamine oxidase inhibitors (MAOIs) are another class of drugs that may be recommended for treating Parkinson's disease. MAOIs inhibit the activity of monoamine oxidase, an enzyme that breaks down dopamine in the brain. By inhibiting the monoamine oxidase enzyme, MAOIs delay the breakdown of naturally occurring dopamine and dopamine formed from levodopa. This can result in mild relief of Parkinson's disease symptoms.
MAOIs approved for treating Parkinson's disease include: Selegiline (Eldepryl, Zelapar, Emsam); Rasagiline (Azilect).
MAOIs are especially prone to serious food and drug interactions, especially when taken at high doses.
Anticholinergics were the main form of treatment before levodopa became available. Their benefit is limited, but they may help control tremors and rigidity. These Parkinson's medications are particularly helpful in reducing drug-induced parkinsonism.
Anticholinergics appear to act by blocking the action of another brain chemical, acetylcholine, whose effects become more pronounced when dopamine levels drop.
Only about half the people who receive anticholinergics respond, usually for a brief period and with only a 30% improvement.
Although not as effective as levodopa or bromocriptine, anticholinergics may have a therapeutic effect at any stage of the disease when taken with either of these drugs.
Specific types of anticholinergic drugs for Parkinson's disease include: Biperiden HCl (Akineton); Trihexyphenidyl (Artane); Benztropine mesylate (Cogentin); Procyclidine (Kemadrin).
Catechol-O-methyltransferase (COMT) inhibitors are medications that are always used along with carbidopa-levodopa in order to improve the effectiveness of levodopa. COMT inhibitor medications include: Entacapone (Comtan), also available in combination with carbidopa and levodopa (Stalevo); Tolcapone (Tasmar).
Rivastigmine (Exelon, Exelon Patch) is an acetylcholinesterase inhibitor, a medication that stops the breakdown of the brain chemical acetylcholine. It is approved to treat mild to moderate dementia due to Alzheimer's or Parkinson's disease. It is not effective for treating other Parkinson's disease symptoms.
An antiviral drug also approved for the flu, amantadine (Symmetrel), can also be used as a Parkinson's disease medication. Amantadine helps reduce the symptoms of Parkinson's. It is often used alone in the early stages of the disease, or with an anticholinergic drug or levodopa.
However, for more details, please seek medical advice, take care.
My wife has MSA, also known under a general name atypical Parkinson's .
She was first diagnosed with Parkinson's . Taking Parkinson's drugs carbidopa/Levadopa helped for 2-3 weeks then had to increase the dosage.
She is currently taking maximum carbidopa/levadopa with diminishing results.
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