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In this section, you or a loved one can find out more about medical treatments, research studies and practical information about Parkinson's disease. Read on to find answers to some of your questions as well as links to other information. Being informed is an important first step towards becoming an active decision-maker in your care plan.
Our ability to move is controlled by nerve cells in the brain. The nerve cells communicate with each other and to the rest of the body using chemicals called neurotransmitters. In healthy people, these messages are transmitted well but, in people with Parkinson’s, the messages are disrupted.
One of the neurotransmitters involved in the control of movement is called dopamine. In people with Parkinson’s disease, the brain cells that make dopamine are damaged and dopamine production is reduced. As the level of dopamine decreases, slowness of movement and stiffness appear. Tremor is associated with the disease in 7 out of 10 cases and can also occur early in the disease course.
Parkinson’s symptoms usually begin on one side of the body but eventually affect the whole body as the disease progresses. Abnormal changes in neurotransmitters other than dopamine are seen in Parkinson’s disease and may be responsible for some of the non-motor symptoms that are linked to the disease.
The cause of Parkinson’s disease is unknown; however, both genetic and environmental factors may play a role. Some people are more likely to develop Parkinson’s disease than others. Factors that may increase risk include:
Specific signs: Motor and non-motor
Initially, the signs and symptoms of Parkinson’s disease may be mild and even go unnoticed.
Motor symptoms and the rate they progress can vary substantially from person to person. Certain motor symptoms are often seen in patients with Parkinson’s disease and are referred to as “cardinal symptoms”. These include tremor when at rest, rigidity, gait and posture problems, and slow movement.
Non-motor symptoms can affect people with Parkinson's at any stage of the disease. Different patients may experience different symptoms; examples of non-motor symptoms include pain and depression (see below).
Parkinson's disease is chronic and progressive, but is not considered to be life threatening. The way that it progresses varies between patients.
How Is the Body Affected?
The following are motor and non-motor symptoms that may be experienced by people with Parkinson's disease.
People with Parkinson’s disease may also experience other symptoms such as pain (in specific areas of the body or all over the body), sexual dysfunction (decrease in sexual desire or performance), bladder problems (for example, being unable to control urine), smell dysfunction (for example, difficulty identifying certain odours) and difficulties in thinking (this usually happens in the later stages of Parkinson’s).
For most people, regardless of having a chronic disease or not, exercise, healthy eating and good sleeping habits are recommended. A healthy lifestyle can lead to an enhanced quality of life for most people. Talk to your doctor before making any lifestyle changes.
People with Parkinson's disease who exercise tend to do better than those who don't exercise. Exercise can improve your quality of life by increasing your level of fitness, strength, flexibility and balance. It may also reduce depression and stress.
Make sure that you discuss any plans for new activities with your doctor. If you experience shortness of breath of severe pain while exercising, make sure that you seek medical attention.
Choose exercises and physical activities that you enjoy. This will help you to stay with your programme and experience positive feelings.
Elements of exercise
A good exercise programme includes different types of exercise such as:
Here are some activities you may want to consider; however, this is not a complete list. Most activities that keep you moving are options. Make sure that you discuss any plans for new activities with your doctor.
Anyone can fall; however, people with Parkinson's disease are at a higher risk of falling due to some of the symptoms of the disease. Falls can lead to accidents and hospitalisation. Knowing what you can do to prevent falls can help to reduce your risk of falling and build your confidence. Here are some things you can do to help prevent falls:
“Complementary therapies are non-conventional health treatments, often based on ancient systems, which many people use alongside standard Western medicine. The range of such therapies is wide, with the majority taking a Holistic approach: that is, treating the patient as a whole, rather than just addressing the symptoms. It is this approach which makes complementary therapies so appealing, particularly to people with Parkinson’s.” - European Parkinson’s Disease Association
Effectiveness of certain medications for Parkinson’s disease can be reduced when combined with drugs for other health conditions. It is therefore important to seek advice from your doctor or pharmacist regarding the use of any new drug.
The main goal of medical treatment for Parkinson’s disease is to reduce the effect of symptoms on your daily life. Medication can have a positive effect on the disease, but it may also have side effects. It is important to balance the therapeutic effect of a medication with its side effects. Timing of when medications are taken can be a key element in maintaining this balance.
Many types of medications are used to treat Parkinson’s disease. All of these treatment options must be validated and discussed with your doctor.
Levodopa is a natural chemical that is converted to dopamine in the brain. It is always given with carbidopa or benserazide, a drug that prevents the degradation of levodopa in the blood allowing the conversion to happen only in the brain. The motor symptoms of people with Parkinson’s disease can improve with levodopa treatment. It is considered to be the most common and efficacious therapy for motor symptoms.
Side effects of levodopa include nausea, vomiting, light-headedness, sleepiness, hallucinations and involuntary movement.
Dopamine agonists stimulate the parts of the brain influenced by dopamine and are used to treat motor symptoms. These drugs mimic the effects of dopamine.
Side effects include nausea, vomiting, light-headedness, sleepiness, hallucinations, leg swelling, weight gain, involuntary movements and impulsive behaviours such as uncontrollable gambling and compulsive shopping.
COMT inhibitors prolong the effect of levodopa by blocking an enzyme that is responsible for breaking down levodopa before transforming it into dopamine. COMT inhibitors may improve response to levodopa, i.e. reduces “off” time.
Side effects include: involuntary movements (mainly resulting from an enhanced levodopa effect), diarrhoea, light-headedness, nausea, vomiting, hallucinations and reduced impulse control.
These medications act by preventing the breakdown of dopamine in the brain. The MOA-B inhibitors can be used for the treatment of early Parkinson’s disease.
Side effects of MAO-B inhibitors include hallucinations, headache, weight loss, nausea and involuntary movement.
Amantadine may provide short-term relief of mild early-stage disease. It may also be used in later stage disease with carbidopa-levodopa therapy to control involuntary movements.
Side effects may include weight gain, thinking problems, dry mouth, nausea, dizziness, insomnia, purple mottling of the skin, ankle swelling or hallucinations.
Anticholinergic medications act by correcting an imbalance between two chemicals in the brain. These medications are used to treat the early symptoms of Parkinson’s and may primarily help reduce tremors.
Side effects include: impaired memory, confusion, hallucinations, constipation, dry mouth and problems urinating.
Please note that the information on this website is intended for informational purposes only and should not be used as a substitute for seeking medical advice or treatment from a healthcare professional. You should not use this information to diagnose or treat a medical condition or health problem. Speak to a healthcare professional if you have any questions about your health, medical condition, symptoms or treatment options.
UK Parkinson’s charity
National Parkinson’s Foundation
The National Parkinson Foundation (NPF) (USA) has focused on meeting the needs in the care and treatment of people with Parkinson’s disease for over half a century. To date NPF has funded more than
$180 million in care, research and support services.
Parkinson’s Disease Foundation
The Parkinson’s Disease Foundation (PDF) (USA) is an American leader in Parkinson’s disease research, education and public advocacy. The PDF works for the nearly one million people in the US who live with Parkinson’s by funding research and educational programmes and services.