Drug treatments for Parkinson’s disease

Lesley Dobson / 08 February 2016

A guide to some of the medication you may be prescribed for Parkinson’s disease.



Medication is one of the treatments available to help treat the effects of Parkinson’s Disease.

Your specialist team will know which medicine is likely to be of most help to you. Here’s our guide to some of the medication you’re likely to be prescribed for Parkinson’s disease.

Related: Read our guide to Parkinson's disease

Levodopa

This drug is a good choice for many people with Parkinson’s. It has been prescribed for Parkinson’s disease for years, and most people taking it find a noticeable improvement in their symptoms.

Levodopa is described as a ‘chemical building block’. Your body turns this drug into dopamine to replace the dopamine that is lost through Parkinson’s.

Levodopa may make you feel sick when you first start taking it, but this doesn’t tend to last long, and is usually quite mild. It can help to relieve your feelings of nausea or sickness if you take levodopa with or after food. However, taking levodopa with a meal that contains protein can prevent the drug being properly absorbed into your system.

You may be able to avoid this problem if you take levodopa at least half an hour before you eat. An alternative is to eat most of your protein in the evening meal. This will allow levodopa to work best during the daytime, when you’ll probably make best use of it.

Check with your GP or specialist team before you make any changes to your diet. They’ll give you advice on the best times to take levodopa.

Madopar

To prevent levodopa being turned into dopamine in your blood stream it is always combined with another medicine. These are:

  • Madopar or Madopar CR 
  • Caramet CR, Sinemet, Sinemet Plus, or Sinemet CR

Combining these drugs means that more levodopa reaches your brain, and is converted to dopamine there. The combination of drugs also means that you’re likely to have fewer side-effects. According to Parkinson’s UK, taking Madopar or Sinemet provides long-term improvement for most people.

The drugs Madopar CR and Sinemet CR are both controlled-release drugs. This means that they allow the levodopa into your body slowly, rather than releasing it all at once.

These controlled-release drugs can also mean that you can increase the amount of time between your doses. They can sometimes also reduce your involuntary movements (known as dyskinesia). You can take these drugs before going to bed, and they will reduce the amount of stiffness you have at night, which may help you have a better night’s sleep.

Dopamine Agonists

Apomorphine

Apomorphine is one of the main treatments for Parkinson’s symptoms.

Apomorphine takes the place of the dopamine that is missing in people with Parkinson’s, and is able to stimulate the nerve cells in their place.

Apomorphine isn’t right for everyone – some people don’t get much benefit from it.  But if this drug helps you there’s usually no reason why you should have to stop taking it.

When you start treatment with apomorphine, you’ll probably begin with a low dose that will slowly increase until your medical team feels that it is at the right level.

You may be prescribed apomorphine or a similar drug on its own, or with the drug levodopa, as this can improve the effect of the dopamine drug.

These drugs are helpful because they can stop you having involuntary movements (dyskinesia). They can also help with other symptoms that don’t involve movement.

Apomorphine (brand name as APO-go) can be given in a number of different ways. These include being injected, and using a pre-filled disposable pen, known as the APO-go PEN, which you can use several times a day. Alternatively, you can have it as an infusion, which means that it is given to you slowly, through a drip in your arm, using a portable pump.

This drug is usually prescribed for people who have had Parkinson’s disease for a while, and whose symptoms aren’t responding well to medication in pill form.

Apomorphine can make you feel nauseous, and may even make you sick. To combat this you can have an anti-sickness drug called domperidone (brand name Motilium), to combat the sickness. You can usually have this anti-sickness drug reduced after a while, and in some cases can stop taking it altogether.

This drug may help if your symptoms have become unpredictable, or if you have been having serious ‘off’ periods. This is when your uncontrollable movements recur, or become worse. This often happens when the drug levodopa wears off.

Related: Read our guide to treatments for Parkinson's disease

Impulsive and compulsive behaviour

Parkinson’s drugs may cause some impulsive and compulsive behaviour in some people.

Ask a member of your medical team to explain the risk of developing impulsive and compulsive behaviour, when taking these drugs, what steps you can take to avoid or cope with this behaviour, and whether there are any other drugs you can have instead.

The opinions expressed are those of the author and are not held by Saga unless specifically stated.

The material is for general information only and does not constitute investment, tax, legal, medical or other form of advice. You should not rely on this information to make (or refrain from making) any decisions. Always obtain independent, professional advice for your own particular situation.