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Parkinson’s Treatment

There is currently no cure for Parkinson’s but treatment is available. From medications, to therapies and exercise there are a variety of options available to self manage symptoms.

Treatments for Parkinson’s

The main aim of Parkinson’s medication is to increase the level of dopamine that reaches the brain. There are two main medications for Parkinson’s: Levodopa and Dopamine Agonists.

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Levodopa

Levodopa

Levodopa is converted to dopamine in the body, which then replenishes the lack of dopamine in the brain of people with Parkinson's.

Levodopa is highly effective in controlling most symptoms of Parkinson’s.

It is usually recommended that levodopa is not taken with food. One of the reasons for this is that dietary protein (found in foods such as meat, fish, eggs, milk, cheese, beans, pulses and nuts or high protein drinks like Ensure or Sustagen) can interfere with the absorption of the medication.

More than 30 years after its discovery, it remains the cornerstone of Parkinson’s treatment, and a vast majority of people with Parkinson's receive levodopa therapy.

Levodopa is converted to dopamine in the body, which then replenishes the lack of dopamine in the brain of people with Parkinson's.

Levodopa is highly effective in controlling most symptoms of Parkinson’s.

It is usually recommended that levodopa is not taken with food. One of the reasons for this is that dietary protein (found in foods such as meat, fish, eggs, milk, cheese, beans, pulses and nuts or high protein drinks like Ensure or Sustagen) can interfere with the absorption of the medication.

More than 30 years after its discovery, it remains the cornerstone of Parkinson’s treatment, and a vast majority of people with Parkinson's receive levodopa therapy.

Dopamine Agonists

Dopamine Agonists

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 people with Parkinson’s.

The drugs are usually started at a low dosage before being 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.

Studies show that the likelihood of developing dyskinesias (involuntary movements) is significantly reduced when people take a dopamine agonist alone, or in combination with a low dose of Levodopa.

With any medication, it is essential 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 medication without consulting your doctor.

The effectiveness of Parkinson’s medications depends greatly on the right 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.

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 people with Parkinson’s.

The drugs are usually started at a low dosage before being 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.

Studies show that the likelihood of developing dyskinesias (involuntary movements) is significantly reduced when people take a dopamine agonist alone, or in combination with a low dose of Levodopa.

With any medication, it is essential 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 medication without consulting your doctor.

The effectiveness of Parkinson’s medications depends greatly on the right 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.

Exercise

Exercise

Exercise is very important for people with Parkinson's. As well as improving general health and well-being, it seems to improve the response of the body to dopamine and may even protect nerve cells from degeneration.  

Everybody with Parkinson's should attempt to get at least 20-30 minutes of exercise each day. Possibilities include walking or exercise classes.  A good approach is to do the exercise you enjoy and therefore are more likely to continue. As to how much, it is the amount you can do again tomorrow without getting progressively exhausted. You can find out more about the importance of Parkinson's specific exercise by reading our booklet 'Parkinson's Specific Exercise Programme and watching brief exercise videos below.

Exercise is very important for people with Parkinson's. As well as improving general health and well-being, it seems to improve the response of the body to dopamine and may even protect nerve cells from degeneration.  

Everybody with Parkinson's should attempt to get at least 20-30 minutes of exercise each day. Possibilities include walking or exercise classes.  A good approach is to do the exercise you enjoy and therefore are more likely to continue. As to how much, it is the amount you can do again tomorrow without getting progressively exhausted. You can find out more about the importance of Parkinson's specific exercise by reading our booklet 'Parkinson's Specific Exercise Programme and watching brief exercise videos below.

Physiotherapy and Occupational Therapy

Physiotherapy and Occupational Therapy

Physiotherapy can help with local problems such as shoulder pain and more general health including exercise programmes. There are physiotherapy programmes that work on movement patterns to help coordination and balance for people with Parkinson’s.

An occupational therapist can assist in maintaining independence both at work and at home by modifying the environment and providing aids for mobility and other adaptive equipment.

Physiotherapy can help with local problems such as shoulder pain and more general health including exercise programmes. There are physiotherapy programmes that work on movement patterns to help coordination and balance for people with Parkinson’s.

An occupational therapist can assist in maintaining independence both at work and at home by modifying the environment and providing aids for mobility and other adaptive equipment.

Speech Therapy

Speech Therapy

Some people with Parkinson’s have difficulty projecting their voice or develop a stuttering speech. A speech language therapist can provide advice and specific strategies to improve communication. As well as providing advice on speech, language, and voice problems, speech-language therapists can also assess and help you manage swallowing difficulties.

Some people with Parkinson’s have difficulty projecting their voice or develop a stuttering speech. A speech language therapist can provide advice and specific strategies to improve communication. As well as providing advice on speech, language, and voice problems, speech-language therapists can also assess and help you manage swallowing difficulties.

Deep Brain Stimulation

Deep Brain Stimulation

Deep Brain Stimulation (DBS) uses mild electrical pulses to stimulate a precisely targeted area of the brain. DBS works by ‘stunning’ the target area, which blocks abnormal nerve signals.

What is Deep Brain Stimulation?

With a Deep brain stimulation surgery, electrodes that can generate electrical signals are implanted to send signals to parts of the brain affected by Parkinson’s.

Cardinal Parkinson’s symptoms, such as tremors, slowness of movement, and stiffness of joints, can be reduced through DBS. Unlike most invasive brain procedures, however, DBS is reversible.

How Does Deep Brain Stimulation Work?

Electrodes are strategically placed on specific parts of the brain to treat Parkinsonism symptoms. Tiny holes are drilled on the skull of the patient to insert the electrodes deep within the brain. Long wires are placed right underneath the skin, to connect these electrodes to a neurostimulator device. Much like a pacemaker for a cardiac patient, this device is used to employ electric signals to moderate brain activity. The neurotransmitter is battery-powered, lasting for anywhere between 2 to 6 years before needing to be replaced. Parkinson’s symptoms, such as tremors and muscle rigidity, are caused mainly by faulty nerve signals arising from brain cell damage. The DBS neurotransmitter, however, will block these signals to reduce these symptoms.

Who Can Have DBS Surgery?

If you have worsening Parkinson’s symptoms and your medications are not effective enough, then you may be recommended to have the DBS procedure done. However, DBS will not be recommended in some instances. These include scenarios where the Parkinson’s patient has severe depression, advanced forms of dementia, or have symptoms that are not typically associated with Parkinson’s.

What Happens After DBS Surgery?

After you have DBS surgery, you may experience slight brain swelling around the portion where the electrode was inserted into the skull. The swelling typically will subside in a few days to a couple of weeks. Most people who have DBS surgery are discharged in about a day.

Risks of Deep Brain Stimulation

As with any medical procedure, there are genuine risks of getting the DBS procedure done. General risks are seizures, infections, blood clots, excessive bleeding, and anesthesia reactions. There is a risk that DBS may lead to speech and balance-related afflictions from Parkinson’s to worsen. DBS can also worsen depression in some people with Parkinson’s.

Life After DBS Surgery

Once the neurotransmitter has been programmed, you are given a handheld controller to make adjustments. With the controller, you can turn the simulator on or off, select the signal strength, and move across different program types. If your DBS neurotransmitter has a rechargeable battery, then it will take about two hours for the device to recharge completely. Make sure to carry your Implanted Device Identification (IDI) card if you are traveling by air, as Airport Security will detect the device.

Deep Brain Stimulation in NZ

In New Zealand, DBS surgery is only carried out on a small number (less than 20) patients each year. This is because there are only certain patients in whom it will work satisfactorily. The majority of these people have Parkinson’s, although DBS is also used to treat some other conditions.

Deep Brain Stimulation (DBS) uses mild electrical pulses to stimulate a precisely targeted area of the brain. DBS works by ‘stunning’ the target area, which blocks abnormal nerve signals.

What is Deep Brain Stimulation?

With a Deep brain stimulation surgery, electrodes that can generate electrical signals are implanted to send signals to parts of the brain affected by Parkinson’s.

Cardinal Parkinson’s symptoms, such as tremors, slowness of movement, and stiffness of joints, can be reduced through DBS. Unlike most invasive brain procedures, however, DBS is reversible.

How Does Deep Brain Stimulation Work?

Electrodes are strategically placed on specific parts of the brain to treat Parkinsonism symptoms. Tiny holes are drilled on the skull of the patient to insert the electrodes deep within the brain. Long wires are placed right underneath the skin, to connect these electrodes to a neurostimulator device. Much like a pacemaker for a cardiac patient, this device is used to employ electric signals to moderate brain activity. The neurotransmitter is battery-powered, lasting for anywhere between 2 to 6 years before needing to be replaced. Parkinson’s symptoms, such as tremors and muscle rigidity, are caused mainly by faulty nerve signals arising from brain cell damage. The DBS neurotransmitter, however, will block these signals to reduce these symptoms.

Who Can Have DBS Surgery?

If you have worsening Parkinson’s symptoms and your medications are not effective enough, then you may be recommended to have the DBS procedure done. However, DBS will not be recommended in some instances. These include scenarios where the Parkinson’s patient has severe depression, advanced forms of dementia, or have symptoms that are not typically associated with Parkinson’s.

What Happens After DBS Surgery?

After you have DBS surgery, you may experience slight brain swelling around the portion where the electrode was inserted into the skull. The swelling typically will subside in a few days to a couple of weeks. Most people who have DBS surgery are discharged in about a day.

Risks of Deep Brain Stimulation

As with any medical procedure, there are genuine risks of getting the DBS procedure done. General risks are seizures, infections, blood clots, excessive bleeding, and anesthesia reactions. There is a risk that DBS may lead to speech and balance-related afflictions from Parkinson’s to worsen. DBS can also worsen depression in some people with Parkinson’s.

Life After DBS Surgery

Once the neurotransmitter has been programmed, you are given a handheld controller to make adjustments. With the controller, you can turn the simulator on or off, select the signal strength, and move across different program types. If your DBS neurotransmitter has a rechargeable battery, then it will take about two hours for the device to recharge completely. Make sure to carry your Implanted Device Identification (IDI) card if you are traveling by air, as Airport Security will detect the device.

Deep Brain Stimulation in NZ

In New Zealand, DBS surgery is only carried out on a small number (less than 20) patients each year. This is because there are only certain patients in whom it will work satisfactorily. The majority of these people have Parkinson’s, although DBS is also used to treat some other conditions.