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Medications

• Your treatment will include medications (called neuroprotective agents) to “protect” the neurons that make dopamine.
  
  
  • Laboratory tests show that the medication selegiline (Eldepryl) gives a neuroprotective effect for dopamine neurons.
    
    
  • When you are given selegiline alone in early PD, it is with the hope that the rate of degeneration of dopamine neurons may be slowed.
  
  
• Symptomatic therapy is begun when you have functional disability. The selection of medication depends in part on the nature and cause of the disability.
  
  
  • If your disability is due solely to tremor, a medication specific for tremors, such as amantadine (Symadine, Symmetrel), an anticholinergic agent, can be used.
    
    
    • This type of medication provides good tremor relief in about 50% of people but does not improve bradykinesia or rigidity.
      
      
    • Because tremor may respond to 1 anticholinergic medication and not another, your doctor may try a second anticholinergic if the first is not successful.
      
      
    • You will be given these medications starting at a low dose and slowly rising to minimize side effects, which include memory difficulty, confusion, and hallucinations. Side effects involving thinking are relatively common, especially in older people.
    
    
  • If your disability is due to bradykinesia, rigidity, decreased dexterity, slow speech, or shuffling gait, you have dopamine-responsive symptoms.
    
    
    • You will be given a medication, such as levodopa-carbidopa (Sinemet), that will increase the dopamine in your brain.
      
      
    • These medications are started at a low dose, slowly escalated, and adjusted to control symptoms.
      
      
    • Most people require this kind of treatment for bradykinesia and rigidity within 1-2 years after diagnosis.