The management of Parkinson’s should be tailored to the individual and includes keeping well and active.
Exercise is very important for people with Parkinson's. As well as improving general health and well-being, it seems to improve the body's response to dopamine. People with Parkinson's should attempt to get at least 20 to 30 minutes of exercise each day. Stretching exercises are particularly beneficial. Always seek expert advice before beginning any exercise programme.
The main aim of drug treatments for Parkinson’s is to increase the level of dopamine that reaches the brain, stimulate the parts of the brain where dopamine works, or block the action of other chemicals that affect dopamine. In most newly diagnosed people considerable improvements can be achieved by the careful introduction of medication.
You will need to work with your doctor to find the right balance of medications to effectively manage the symptoms of your condition. Your doctor will also need to check your responses to medications as you receive them, in case adjustments of dosage or timing need to be made.
Sometimes when somebody only has mild symptoms of Parkinson’s, their doctor may decide that it is best to postpone drug treatment for a while, and instead focus on lifestyle changes like exercise and relaxation.
The two main drug treatments for Parkinson’s are:
Levodopa is converted to dopamine in the body, which then replenishes the lack of dopamine in the brain. Levodopa is highly effective in controlling most symptoms of Parkinson’s. More than 30 years after its discovery it remains the cornerstone of Parkinson’s disease therapy, and a large majority of patients receive levodopa therapy.
Dopamine agonists stimulate the natural dopamine rather than replacing it in the way that levodopa does. Dopamine agonists mimic the signal from dopamine that is lost in Parkinson’s.
The drugs are usually started at a low dose and increased slowly to reduce any possible side effects. Several clinical studies have shown that dopamine agonists can be effective treatments for several years when used alone and the likelihood of developing dyskinesias (involuntary movements) is greatly reduced while people remain on a dopamine agonist alone or in combination with a low dose of levodopa.
With any medication it is important to remember that everyone will react to it in different ways. It is essential not to make any changes to your medication, or stop taking your mediation without consulting your doctor. It is also important that you know what other medications should not be taken with Parkinson’s drugs, and whether your drugs should be taken before or after food.
Get it on time
The effectiveness of Parkinson’s medications depends greatly on the medication being taken at the right time. Work out with your doctor which times are best for you, and ensure that any carer’s, family members, rest-home or hospital staff are informed of the importance of taking your medication at the correct time.
For more information on the medical management of Parkinson’s, see Medication used in the Treatment of Parkinson's: a guide for people with Parkinson's and those who care for them.