How is Parkinson’s Disease Managed?

Parkinson’s Disease

It is important to mention people with Parkinson’s should have good holistic integrated care not only with drugs but also with other strategies such as physiotherapy, exercise (including dancing therapy) and patient education.

Therapeutic treatment in managing the motor symptoms in Parkinson’s Disease is aimed at correcting dopamine deficiency in the brain – and provide symptomatic benefit of motor/movement symptoms and treatment is started when required from a functional point of view to maintain function and quality of life.

Current medications include Levodopa (still the Gold Standard of treatment), Dopamine Agonists, MAO-B inhibitors, COMT inhibitors and Amantadine.

There are three main advanced therapy options on the concept of “Continuous  Dopaminergic Stimulation” for reducing motor complications in Parkinson’s Disease refractory to optimal conventional dopaminergic treatment :

1. Deep Brain Stimulation.
2. Apomorphine pump based therapy.
3. Levodopa Carbidopa Intestinal through a  gastrostomy tube.

As people with Parkinson’s Disease are often over the age of 65 years they often also have other medical conditions, polypharmacy and a wide range of non motor symptoms particularly neuropsychiatric symptoms and are herefore best cared for by a Geriatrician with a special interest and expertise in Parkinson’s Disease.

The above article was written by Dr Soumit Singhai (Parkinson’s Disease Specialist based at 25 Harley Street in London)