Other Drugs Used To Treat Parkinson’s Disease

In addition to L-dopa and dopamine agonists which either provoke the body into making dopamine, or fooling the body into thinking that it’s making enough dopamine, there are other drugs that are used to treat Parkinson’s disease. Several of them help increase the effectiveness of L-dopa by blocking enzymes that break down dopamine, so that dopamine stays in your system longer. Others treat other symptoms of Parkinson’s directly.

Selegiline
(Atapryl, Carbex, Eldepryl) Selegiline is often prescribed with L-dopa to help prevent the body from breaking down dopamine before it is used. It’s called an MAO-B inhibitor because it slows down the actions of the enzyme MAO-B (monoamine oxidase B) which is responsible for breaking down dopamine in the nerve receptors. Some patients who have taken selegiline with Demerol have experienced toxic effects.

COMT Inhibitors
A relatively new class of drug that’s used in treating the symptoms of Parkinson’s disease are known as COMT inhibitors. Like selegiline, they prolong the effects of L-dopa by preventing the breakdown of dopamine in the liver instead of by the nerve cell receptors. One COMT inhibitors, Tasmar, has been associated with liver damage, and is typically only prescribed for patients who are not responding to other types of therapy. Another COMT inhibitor, entacapone, may help manage fluctuations of motion that occurs in patients who are taking L-dopa. It has not been associated with liver damage at all.

Anticholinergics
An older class of drugs that are sometimes still used to treat Parkinson’s in some cases are called anticholenergics. Before the discovery of L-dopa, they were the primary treatment, but are seldom used now because their side effects offset the benefits in many cases. Anticholinergics help control tremors in the early stages of Parkinson’s, but the side effects include dry mouth, severe constipation, urine retention and mental problems like confusion, hallucinations and memory loss.

Some of the anticholinergics that your doctor may prescribe include tryhexiphenidyl (Artane) and benztropine (Cogentin). In addition, there are other drugs that work like anticholinergics which may be prescribed for older adults who can't tolerate the side effects of true anticholinergics. Those include diphenhydramine (Benadryl) and antidepressants like amitryptiline.

Amantadine (Symadine, Symmetrel)
Amantadine is an antiviral drug that may help alleviate the dyskinesia associated with taking L-dopa. It is most often prescribed in the later stages of Parkinson’s disease. Its side effects include swollen ankles and a purple discoloration (mottling) of the skin.

Coenzyme Q10
Coenzyme Q10 is a substance that carries electrons during some of the cell processes. People with Parkinson’s disease often have low levels of Coenzyme Q10 and may benefit from taking supplements that contain it. It’s available over the counter in drug stores and health food stores. Like any other alternative treatment, you should be sure to let your doctor know that you’re using it.





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