| Parkinson's disease is a degenerative disorder of the | | | | develop a forward or backward lean and to fall easily. |
| central nervous system. Parkinson's disease occurs | | | | Parkinson's disease requires broad-based |
| when nerve cells, or neurons, in an area of the brain | | | | management including patient and family education, |
| known as the substantia nigra die or become | | | | support group services, general wellness maintenance, |
| impaired. Normally, these neurons produce an | | | | exercise, and nutrition. Medications can help manage |
| important brain chemical known as dopamine. At least | | | | problems with walking, movement and tremor by |
| 500,000 people in the United States currently have | | | | increasing the brain's supply of dopamine. Amantadine |
| PD. Parkinson's disease belongs to a group of | | | | may also be added to carbidopa-levodopa therapy |
| conditions called movement disorders. Parkinson's | | | | for people in the latter stages of Parkinson's disease. |
| disease is progressive, meaning the signs and | | | | Catechol-O-methyltransferase (COMT) inhibitors drugs |
| symptoms become worse over time. But although | | | | prolong the effect of carbidopa-levodopa therapy by |
| Parkinson's disease may eventually be disabling, the | | | | blocking an enzyme that breaks down dopamine. |
| disease often progresses gradually. Parkinson disease | | | | Tolcapone (Tasmar) is a potent COMT inhibitor that |
| affects movement (motor symptoms). Typical other | | | | easily crosses the blood-brain barrier. A medicine |
| symptoms include disorders of mood, behavior, | | | | called levodopa is often given to people who have |
| thinking, and sensation (non-motor symptoms). | | | | Parkinson's disease. Called "L-dopa," this medicine |
| Individual patients' symptoms may be quite dissimilar | | | | increases the amount of dopamine in the body and |
| and progression of the disease is also distinctly | | | | has been shown to improve a person's ability to walk |
| individual. Parkinson's usually begins around age 60. It | | | | and move around. Thalamotomy involves the |
| is more common in men than in women. Symptoms | | | | destruction of small amounts of tissue in the |
| of Parkinson's disease often start on one side of the | | | | thalamus — a major brain center for relaying |
| body first and then affect both sides. | | | | messages and transmitting sensations. |
| There are many secondary symptoms associated | | | | Parkinson's Disease for Treatment Tips |
| with Parkinson's disease. Parkinson's disease patients | | | | 1. Carbidopa and benserazide are dopa decarboxylase |
| may notice that they are weaker or more tired. | | | | inhibitors. |
| Symptoms include disorders of mood, behavior, | | | | 2. Tolcapone inhibits the COMT enzyme, thereby |
| thinking, and sensation. Poor balance is due to the | | | | prolonging the effects of L-dopa, and so has been |
| impairment or loss of the reflexes that adjust | | | | used to complement L-dopa. |
| posture in order to maintain balance. Falls are | | | | 3. Selegiline and rasagiline reduce the symptoms by |
| common in people with Parkinson's. Shaking (muscle | | | | inhibiting monoamine oxidase-B (MAO-B). |
| tremor). This is one of the first symptoms in | | | | 4. An antiviral drug, amantadine, can help reduce |
| three-quarters of people, and affects most people | | | | symptoms of PD and levodopa-induced dyskinesia. |
| with Parkinson's disease. Bradykinesia is the | | | | 5. COMT (catechol O-methyl transferase) inhibitors |
| phenomenon of a person experiencing slow | | | | are a new class of drugs that stop the breakdown |
| movements. In addition to slow movements, a | | | | of dopamine. |
| person with bradykinesia will probably also have | | | | 6. Other therapies that are important for managing |
| incomplete movement, difficulty initiating movements | | | | and coping with Parkinson's disease include |
| and sudden stopping of ongoing movement. The | | | | physiotherapy, speech therapy, and occupational |
| progressive loss of voluntary and involuntary muscle | | | | therapy. |
| control produces a number of secondary symptoms | | | | 7. Amantadine acts like a dopamine replacement drug |
| associated with Parkinson's. Postural instability, or | | | | but works on different sites in the brain. |
| impaired balance and coordination, causes patients to | | | | |