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Parkinson's Disease

Treating Parkinson's: A Brief Overview of Options

Summary & Participants

There is still no cure for Parkinson's disease. But patients can fight its symptoms with treatments ranging from traditional medications to new brain stimulation techniques. How do they work, and what are their pros and cons? Tune in as experts talk about the various options that can help patients become more active and mobile.

Medically Reviewed On: July 08, 2008

Webcast Transcript

ANNOUNCER: Nearly 1 million Americans suffer from Parkinson's disease. While there's no cure for the condition, most patients are able to receive effective treatments to reduce symptoms and help remain active. To help improve patient quality of life oral medications, device therapy and surgical options are available.

WILLIAM J. MARKS, JR., MD: Major treatment options for Parkinson's disease include various medications as well as surgical therapies. A number of medications are highly effective at reducing the symptoms of Parkinson's disease and depending on the stage of the disease and a number of other factors that will affect which medications are selected for each patient.

HELEN BRONTE-STEWART, MD: The current most helpful medication is actually the first medication that was discovered to really help Parkinson's disease and that's Levodopa. And Levodopa is a medication that is transformed in the brain into dopamine, which is the deficient neurotransmitter in the brain.

ANNOUNCER: In Parkinson's disease there is a deterioration of dopamine producing and transmitting neurons. As a result, the brains of people with Parkinson's disease contain almost no dopamine. Levodopa, along with medications like dopamine agonists, make up for that loss.

LUCIAN CÓTÉ, MD: The latest medications that we have to treat Parkinson's disease are those drugs that mimic the substance which is reduced in the brain of Parkinson patients, i.e., dopamine. These are called dopamine agonists. That includes ropinirole, pramipexole, and then two older dopamine agonists that are still being used: bromocriptine and pergolide. I must emphasize that the gold standard is still Sinemet, which is a combination of levodopa and carbidopa.

BLAIR FORD, MD: The problem with the medications is that after five years or more, although they still continue to work, they have side effects, and the side effects include the wearing off problem, the dyskinesia problem. These problems are manageable with a change in medication.

ANNOUNCER: But advanced Parkinson's patients whose medications offer little help can turn to Device therapies such as Deep Brain Stimulation. It's proven effective in targeting motor control, but is not a cure. Also this procedure is only offered to a few select patients who are in the advance stages of the disease and no longer respond to medication therapies.

BLAIR FORD, MD: The most effective neurosurgical treatment for Parkinson's disease at the moment is deep brain stimulation.

HELEN BRONTE-STEWART, MD: Deep brain stimulation is rather like a pacemaker for the brain. We insert an electrode into these specific regions of the brain and the electrode is attached through a wire to a pacemaker that sits under the skin in the patient's chest, just like a cardiac pacemaker. But this pacemaker is on all the time, instead of the pacemakers in the heart, which are demand pacemakers. So the patient's brain is being stimulated at high frequencies constantly with electrical pulses And we have found that when that electrode is put very carefully in exactly the right place, this can really ameliorate most signs of Parkinson's disease.

WILLIAM J. MARKS, JR., MD: The advantages of deep brain stimulation include the fact that we can adjust the therapy to maximize relief of symptoms and that it appears that we can use this treatment on both sides of the brain much more safely than with the older treatments.

ANNOUNCER: Besides the general risks of surgery, patients undergoing deep brain stimulation should be aware of other possible complications like temporary swelling around the eyes and the development of infection around the device. So finding the right therapy is key. Because Parkinson's affects each patient differently, it's important that the right combination therapy is administered for effectively taking control of the disease.