Parkinson’s Medications: Individualised Treatment Plans
Parkinson’s medications are the foundation for managing primarily your motor symptoms and boosting your overall quality of life. Your neurologist will work with you to determine the right types, doses, and timing for your medications after a thorough consultation. These treatment plans are tailored to target the symptoms that are most troublesome for you, whether that’s tremor, rigidity, or mobility issues. Sticking to the prescribed schedule is vital, as consistency helps maintain a steady level of medication in your system, reducing symptom fluctuations and maximising benefits. If you have non-motor symptoms like constipation or continence issues, sleep and mood changes, also bring this up with your neurologist or Parkinson’s nurse so you can treat what is bothering you most.

Understanding side effects and interactions
No medication comes without potential side effects, and Parkinson’s treatments are no different. Some side effects may affect your day-to-day life or even put an extra burden on your care partner. It’s essential to have regular reviews with your care team to discuss any issues you may experience. Always consult with your Parkinson’s Nurse Specialist, GP, or pharmacist before making any changes, especially if you’re considering new medications, herbal supplements, vitamins, or natural remedies. Since these substances can interact with your prescribed medications, professional advice is critical to avoid unwanted or serious interactions.

Adapting treatment over time
Parkinson’s is a progressive condition, meaning that your treatment needs may change over time. When symptoms become less responsive to your current medication regimen, your doctor might suggest adjustments. Tools such as a Home Medicines Review (HMR) are available in Australia—during an HMR, a pharmacist visits you at home to review all your medications and supplements. This helps in developing a comprehensive medicine management plan tailored to your evolving condition. Additionally, Dose Administration Aids (DAAs), often described as Webster-paks, organise your medication doses in a tamper-evident device. These aids simplify managing your treatment schedule, especially if multiple doses are required throughout the day.

Support systems in Australia
In Australia, the support extends beyond just medical advice. Support workers who assist with medication management are required to have specialised training and certification. This ensures that you receive safe and effective help when managing your medication routine, which can be particularly valuable if you experience challenges with timing or coordination.

Categories of Parkinson’s medications
Parkinson’s treatments typically fall into several broad categories, and often a combination is used to manage your symptoms effectively. The main types include:

  • Levodopa: The gold standard for treating Parkinson’s for over 60 years, levodopa converts into dopamine in the brain, while other ingredients e.g. benzerasides or carbidopa helps minimise the side effects by slowing down its breakdown before it reaches the brain. (Think of dopamine replacement as the same concept for diabetics who have to replace the insulin their body doesn’t make anymore. You aren’t making dopamine anymore and need to replace it so that your body has enough to function.)
  • Anticholinergics: Often used to manage tremor and muscle rigidity by balancing neurotransmitter levels, though they may be less suitable for older patients due to certain side effects.
  • Dopamine Agonists: These medications mimic the effects of dopamine and are sometimes used in the early stages of Parkinson’s or alongside levodopa to enhance symptom control.
  • MAO-B Inhibitors: They work by slowing the breakdown of brain dopamine, thereby extending its beneficial effects.
  • COMT Inhibitors: COMT inhibitors help to prolong the action of levodopa by inhibiting its breakdown in the body, ensuring that more of the medication reaches your brain.
  • Amantadine: This medication can help ease both the motor symptoms and dyskinesia (involuntary movements) that sometimes occur with longer-term treatment.

Reflecting on treatment choices, the Michael J. Fox Foundation underscores the importance of levodopa by noting, “No drug or surgery has been shown to be superior to levodopa for PD, so avoiding levodopa may result in worse overall quality of life.” This highlights why, despite the range of available medications, levodopa-based treatments often remain a critical element in managing Parkinson’s.

The Road Ahead
Managing Parkinson’s through medication is a dynamic process, requiring ongoing evaluation and adjustments. Your care team—including your neurologist, GP, Parkinson’s Nurse Specialist, and pharmacist—is there to help navigate these changes so that your treatment remains effective as the condition evolves. By working together, you can develop a plan that not only controls symptoms but also helps you maintain your independence and quality of life. Understanding more about each medication and what the effects might be on you is critical to getting the brain chemistry changes right for your symptoms over time. Be sure that your neurologist works with you to optimise your medications; if they are reluctant to change things if they aren’t working for you, you can seek advice from your Parkinson’s Nurse. Most people are not on their initial does for long due to the progressive nature of Parkinson’s.

References

Michael J. Fox Foundation for Parkinson’s Research. (n.d.). Medications for Parkinson’s. Retrieved from (https://www.michaeljfox.org/)

National Institute for Health and Care Excellence. (2017). Parkinson’s disease in adults: Diagnosis and management (NICE guideline NG71)*. Retrieved from (https://www.nice.org.uk/guidance/ng71)

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