Parkinson's Disease - Levadopa (L-dopa)

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Highlights	Symptoms	Surgery
Introduction	Diagnosis	Lifestyle Changes
Causes	Treatment	Resources
Risk Factors	Levadopa (L-dopa)	References
Complications	Other Medications

Dementia. The cholinesterase inhibitor drugs donepezil (Aricept) and rivastigmine (Exelon) are used to treat Alzheimer’s disease and are sometimes used for Parkinson’s. The benefit from these drugs is often small, and patients and their families may not notice much change.

Daytime Sleepiness and Fatigue. Modafinil (Provigil), a drug used to treat narcolepsy may be helpful for patients with sleepiness related to their disease. Methylphenidate (Ritalin) may be considered for patients who experience fatigue.

Erectile Dysfunction. Sildenafil (Viagra) can be helpful for men with Parkinson's disease who suffer from erectile dysfunction. However, the drug may worsen orthostatic hypotension (lightheadedness or dizziness that occurs when suddenly standing up), a side effect of some PD medications.

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Constipation. Laxatives that contain macrogol (polyethylene glycol) may be helpful for improving constipation. Brand names include Softlax, Miralax, and Glycoprep.

Drooling. Glycopyrrolate, scopolamine, and botulinum toxin may be used to relieve drooling symptoms.

Treating Advanced Disease

Advanced Parkinson’s disease poses challenges for both patients and caregivers. Eventually, symptoms such as stooped posture, freezing, and speech difficulties may no longer respond to drug treatment. Surgery (deep brain stimulation) may be considered for some patients. Patients become increasingly dependent on others for care and require assistance with daily tasks. Modifications (wheelchair ramps, grab bars and handrails) may need to be made in the home. Some patients may need to move to an assisted living facility or nursing home. The goal of treatment for advanced Parkinson’s disease should be on providing patients with safety, comfort, and quality of life.

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Review Date: 06/18/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).