Treatment

Parkinson's disease can be managed with drugs, physical therapy, and surgical interventions. The goals of treatment for Parkinson's disease are twofold:

• To relieve disabilities.
• To balance the problems of the disease with the side effects of the medications.

Treatment is very individualized for this complicated disease. Patients must work closely with physicians and therapists throughout the course of the disease to customize a program suitable for their particular and changing needs. Patients should never change their medications without consulting their physicians, and they should never stop taking their medications abruptly.

Treatments by Stage of Parkinson's Disease
Text Continues Below Onset of Mild Symptoms	Lifestyle Changes (Exercise, Diet) Drugs (used alone): Amantadine Selegiline Anticholinergic (for tremor)
Onset of Moderate Symptoms	Levodopa (L-dopa) Dopamine agonists supplemented with L-dopa as necessary Selegiline Catechol-o-methyl transferase inhibitor (not effective alone)
Long-Term Maintenance: Drugs Used with L-Dopa	Effective: Dopamine agonists (pergolide, pramipexole, cabergoline, bromocriptine); Catechol-o-methyl transferase inhibitors (entacapone) Likely to be effective: Dopamine agonists (apomorphine, lisuride); amantadine; anticholinergics Investigational:Rasagiline, rotigotine, safinamide, piribedil, rivastigmine
Advanced Disease	Experimental Drugs Surgical or other procedures, usually deep brain stimulation

Levodopa (L-Dopa)

Levodopa, or L-dopa, has been used for years and is the gold standard for treating Parkinson's disease. It is converted to dopamine in the brain and so acts as a replacement drug. It is used in nearly all phases of the disease. The standard preparation combines levodopa with an anti-nausea agent carbidopa (Sinemet, Atamet).

Treatments for Onset of Parkinson's Disease