Parkinson’s Disease Medications
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Dopamine-Like Medication
Sometimes referred to simply as levodopa, or L-DOPA, the drug eventually becomes dopamine that your brain can use.
Dopamine can’t be taken directly as a treatment because it’s broken down in the body before it reaches the brain.
Other possible side effects of levodopa include nausea, vomiting, sleepiness, and orthostatic hypotension, or low blood pressure that occurs when standing up after sitting or sitting up after lying down.
The practice guidelines note that in early Parkinson’s, taking levodopa with meals may decrease nausea, but in later stages of the disease, doing so may decrease the drug’s therapeutic efficacy due to food competing with levodopa for absorption from the gut.
Certain drug treatments have been developed specifically to treat off episodes. These include Inbrija, an orally inhaled form of levodopa, and istradefylline (Nourianz), a medication taken alongside levodopa.
Dopamine Agonists
These medications mimic the action of dopamine in the brain and can have side effects similar to those of levodopa. They may be taken alone or with levodopa.
According to the aforementioned guidelines for treating early Parkinson’s, dopamine agonists are more likely than levodopa to cause impulse control disorders, excessive daytime sleepiness, and sleep attacks. They may also be more likely to cause hallucinations. And, like levodopa, they can contribute to orthostatic hypotension.
Still, individual characteristics such as body size, sex, and disease severity also influence the likelihood of experiencing certain drug side effects, which is why people who are in the early stages of Parkinson’s disease should talk with their doctor about the potential benefits and risks of these medications before starting any of them.
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MAO-B Inhibitors
Sometimes, an MAO-B inhibitor is taken with levodopa to prolong the effect of that drug.
However, taking these drugs at the same time as certain antidepressants and sedatives should be avoided or monitored closely by your doctor because of potentially dangerous interactions.
Common side effects of MAO-B inhibitors include mild nausea, dry mouth, lightheadedness, and constipation.
The practice guidelines note that MAO-B inhibitors are less effective than levodopa at improving mobility in early Parkinson’s and are additionally associated with a higher risk of drug discontinuation because of side effects.
Your doctor can help you decide whether this kind of medication is a good choice for you.
COMT Inhibitors
This group of drugs includes entacapone (Comtan), opicapone (Ongentys), and tolcapone (Tasmar).
The most common side effect of COMT inhibitors is diarrhea. They may also cause sleep disturbances, dizziness, or hallucinations.
Tasmar has been shown to cause severe liver disease in some people, so you may need to undergo regular blood tests to assess your liver function if you take it.
Amantadine (Symmetrel)
Amantadine (Symmetrel) is an antiviral medication that may increase the effects of dopamine in the brain. Researchers are unsure why amantadine helps in this area.
Amantadine is sometimes taken by itself early in the course of Parkinson’s disease. It may also be taken later on to help with dyskinesia caused by levodopa.
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