A must-read for Parkinson's patients! These six categories of drugs have their own unique abilities. How to accurately match them to your needs?

Parkinson's disease is a common chronic degenerative disease of the nervous system. As the disease progresses, it affects the patient's limb function and non-motor symptoms. Drug therapy is the main treatment for Parkinson's disease, but if it is not taken properly, it will accelerate the development of the disease.

(1) Dopamine preparations

Compound levodopa includes two compound preparations: dopamine and benserazide. Dopamine contains two ingredients: levodopa and benserazide, while benserazide contains two ingredients: carbidopa and levodopa.

Levodopa is the standard treatment for Parkinson's disease and is currently the most effective treatment;

Benserazide and carbidopa help improve the adverse reactions of peripheral tissues caused by levodopa and enhance the therapeutic effect of levodopa.

When using levodopa for treatment, you should start with a small dose and use the lowest possible dose to reduce the occurrence of motor complications while meeting the symptom control requirements. Compound levodopa has both immediate-release and sustained-release formulations. Immediate-release formulations take effect quickly, while sustained-release formulations take effect slowly but last longer, so you need to be careful when switching between formulations.

(2) Dopamine receptor agonists

Dopamine receptor agonists: including ergots and non-ergots. Ergots are now less used. Currently, the main recommended drugs are non-ergot drugs including pramipexole, ropinirole, etc.

The combined use of levodopa and dopamine receptor agonists in the early stages of the disease can fully utilize the synergistic effects of the two types of drugs and delay the occurrence of adverse reactions. It should be noted that most dopamine receptor agonists have the risk of drowsiness and psychiatric adverse reactions, so they should be used starting with a small dose and gradually increased to the minimum dose that achieves a satisfactory therapeutic effect for maintenance treatment.

(3) Monoamine oxidase type B inhibitors

Monoamine oxidase inhibitors selegiline and rasagiline: They have a good effect on improving the motor symptoms of early patients and can also be used for combined drug treatment in the advanced stage. When taking selegiline, you should avoid taking it in the evening or at night to avoid insomnia.

(4) Catechol-O-methyltransferase inhibitors

Catechol Oxymethyltransferase inhibitors (entacapone): need to be used in combination with levodopa. They are ineffective when used alone. They can improve motor symptoms in the early, middle and late stages of the disease.

(5) Anticholinergic preparations

Anticholinergics (benzhexol): Mainly suitable for patients with tremor. The dosage should be strictly controlled and the patient's cognitive function should be closely monitored.

(6) Amantadine

Amantadine: It improves hypokinesia, rigidity, and tremor, and is also effective for movement complications caused by levodopa.

Cheng Junqun, director of the Department of Neurosurgery at Changsha Yuxiang Hospital, said: The treatment of Parkinson's disease is a complex and long-term process, which requires comprehensive consideration of the patient's symptoms, age, physical condition and other factors to develop an individualized treatment plan. The above six categories of drugs each have their own advantages and disadvantages, and need to be used reasonably under the guidance of a doctor to achieve the best treatment effect.

Of course, for Parkinson's patients' non-motor symptoms (depression, constipation, frequent urination, etc.), drugs should also be used for symptomatic treatment to improve the quality of life of Parkinson's patients. For patients with excessive drug effects or serious side effects, especially those in the middle and late stages, deep brain stimulation can also be considered for treatment to alleviate symptoms and improve quality of life.

However, it should be noted that the current treatment methods can only improve symptoms and improve the quality of life, but cannot cure the disease. Therefore, the treatment of Parkinson's disease should not only focus on the current situation, but also on long-term management to achieve long-term benefits. Of course, with the continuous advancement of medical research, new treatment methods and drugs are constantly emerging, bringing more hope and choices to patients.

Source: Department of Neurosurgery, Changsha Yuxiang Hospital

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(Edited by YT)