Therapy for PD usually involves the following:
• Treating the symptoms that undermine your quality of life.
• Possibly modifying the progression of PD.
• Medication to address troublesome symptoms or adjusting the treatment as the condition changes.
• Occupational therapy, physiotherapy, speech therapy, exercise and general lifestyle modifications.
According to Dr Michael Okun, National Medical Director for the US National Parkinson Foundation and author of several books on the illness, the most important factor in initiating medication for a patient is “whether Parkinson’s symptoms are affecting quality of life, or alternatively whether symptoms are affecting work performance”.
He stresses there’s no benefit in delaying medication therapy if an individual experiences bothersome symptoms. Delaying treatment may also be risky, especially if the delay results in unsteadiness, falls and fractures. The best advice Dr Okun offers PD patients is “not to fear treatment”.
Given that deficient dopamine in the brain causes most PD symptoms, many Parkinson’s drugs either temporarily replenish dopamine or imitate the action of dopamine. Called dopaminergic drugs, these medications usually help to reduce tremor and muscle rigidity while improving speed and coordination of movement.
Levodopa is the most widely prescribed medication for PD and is best taken on time before the previous dose wears off. Some patients may also take other drugs to treat non-motor symptoms and PD-related cognitive disruptions, which can precede the onset of motor symptoms by as much as ten years.
Surgical options such as deep brain stimulation (DBS) may help to ease symptoms in some cases where people stop responding to medication. However, DBS only benefits a small number of patients.