Combined drug for the treatment of parkinsonism. Modern principles of treatment of parkinsonism. Various Treatment Options for Parkinson's Disease

Free medications are issued according to a valid prescription from the attending physician. Dispensing is carried out only by pharmacies that have entered into an agreement for reimbursement of costs with the pension fund.

Drugs in the treatment of Parkinson's disease must first of all replenish the missing dopamine in the patient's body.

But the severity of the disease requires the prescription of auxiliary medications - sleeping pills to normalize sleep, painkillers to alleviate the severe conditions of patients.

The maximum treatment effect is achieved by taking vitamins and antioxidants.

Also used to treat the disease are neurosurgical treatments, physical therapy, the help of a psychologist, and exposure to medical devices.

This article will discuss Parkinson's disease - treatment with tablets and how to use them, as well as some other aspects of drug therapy.

General information

So, the disease, which received its name from the name of the person who discovered it, is a serious illness that cannot be cured. The only thing that can be achieved is to reduce symptoms and prolong the patient’s normal life.

The main symptoms characteristic of Parkinson's disease are:

You can read more about this disease here.

The main cause of Parkinson's disease is a lack of dopamine in the body, or rather, problems with its production due to nervous disorders. The most important goal of drug therapy is to compensate for the lack of dopamine in the patient’s body in order to delay the onset of a severe form.

Prescribing drugs is only within the competence of the attending physician, since when selecting a dosage, a huge number of factors are used, from the patient’s age to the characteristics of his body in the perception of certain medicinal elements.

All information provided below is for reference only; under no circumstances prescribe treatment for yourself or calculate the dosage, as this can lead to dire consequences.

Treatment at the initial stage

Treatment with tablets at the initial stage can slow down the development of the disease for several years, so it is important to consult a doctor as early as possible.

Levodopa can be put in first place among medicines. This medicine acts as an artificial dopamine.

The use of levodopa initially replaces its own dopamine, which the patient’s body can no longer produce in sufficient quantities.

Why is it impossible to prescribe levodopa to a person and, using this drug regularly, completely forget about the disease? The fact is that the body gradually adapts to synthetic dopamine and begins to demand more.

In turn, increasing the dosage will lead to a reverse reaction of the body, side effects (nausea or vomiting) and therefore inhibitors are used in combination with these tablets.

An inhibitor is a substance that slows down the process of absorption of the active substance by the body (in our case, levodopa).

Inhibitors allow levodopa to remain in an inactive or conditionally inactive state for a long time.

For example, when a regular capsule with levodopa enters the body, the shell of this capsule will dissolve in a matter of minutes and the active substance will enter the blood as quickly as possible.

If levodopa is used in combination with an inhibitor, levodopa will be absorbed into the blood slowly, which will delay as much as possible the onset of the moment when the body begins to require an increase in the dosage of the medicine for the disease.

The most common inhibitors are:

• carbidopa (drug Nakom, Stalevo);
• benserazide (Madopar);
• selegelin.

In addition, it is possible to replace levodopa with dopamine receptor agonists (DRAs).

An agonist is a drug that causes a response in a particular receptor, thereby causing it to perceive or reproduce the substance required by the patient

However, these agonists are used in later stages of the disease or when levodopa is no longer effective. It is also possible to take it in combination with levodopa.

Agonists include:

Treatment in later stages

What drugs for Parkinson's disease are used in the later (advanced) stages of the disease?

As a rule, only the dosage is subject to changes, which increases over time.

Gradually, drugs that are effective in the early stages are poorly accepted by the body, and increasing the dose entails severe side effects. In such a situation, the doctor replaces levodopa with dopamine receptor agonists.

The main signal indicating low effectiveness is a decrease in the patient’s social life, deterioration in his motor activity, and an increase in the main symptoms of the disease.

Moreover, as mentioned earlier, agonists taken in combination with levodopa will reduce the dosage of this substance by 1/4.

Vitamins

In addition to drug therapy, the body definitely needs vitamin support. Thus, to support a patient with Parkinson’s disease, a vitamin complex is indispensable, including vitamins B, C, E. In addition, nicotinic and linoleic acids should be included in the vitamin diet.

Side effects

When using potent drugs, naturally, the patient will begin to develop side effects, which, in turn, are divided into:

The most pronounced side effects are early ones. This group of side effects occurs almost at the very beginning of drug treatment, in contrast to later ones, which can occur several years later (due to the accumulation of a particular drug in the body).

There are side effects:

As for late side effects, additional medications may be prescribed to eliminate them (early ones are corrected by reducing the dosage), sedatives for psychoses, etc.

The main side effects caused by Parkinson's pills:

• levodopa in interaction with carbidopa or benserazide - nausea, vomiting, low blood pressure, tachycardia, hyperhidrosis, sleep problems, hypersexuality, hallucinations;
• levodopa in interaction with carbidopa and entacapone - nausea or dyskinesia;
• bromocriptine (ADR) - low blood pressure, nausea, vomiting, psychosis, stomach bleeding, sleep problems;
• pramipexole (ADR) - nausea, vomiting, hallucinations, sleep problems, swelling;
• piribedil (ADR) - nausea, vomiting, drowsiness;
• selegiline and rasagiline (Inhibitors) - sleep problems, increased side effects of levodopa.

New developments

What other means besides pills can be used to treat Parkinson's disease?

There is a patch that is considered a relatively new product. This patch is glued to the patient’s lower back and the active substance begins to enter the body gradually, and not all at once, as when taking tablets.

A number of studies are currently being conducted that could make a significant breakthrough in the treatment of this disease. Thus, the development of an inhalation method is in its final stage, which will virtually eliminate interruptions in the supply of levodopa to the body.

In addition, scientists are developing a treatment method in which the medicine will be injected directly into the basal ganglia, which will eliminate the destruction of the nervous system.

In addition, scientists are studying the mechanism of development of the disease at the gene level and have even achieved some success; a special gene has been isolated that has the ability to regenerate, however, in order to use this property in the interests of treating Parkinson’s, there is not enough information about the presence of side effects.

Thus, the treatment of Parkinson's disease is a complex and multifaceted process that requires constant monitoring by doctors. You should not try to fight this disease on your own, as you can only worsen your situation. Take care of yourself and treat yourself correctly!

New drug against Parkinson's disease

Heptachlor is an ancient pesticide that was widely used three decades ago and is still found in cow's milk around the world. Recently, Japanese researchers suggested that this toxic substance may be one of the causes of Parkinson's disease.

Researchers in the UK are working on technology to diagnose and monitor Parkinson's disease by smell. Scientists were inspired to do this by a woman who has the unique ability to detect a disease simply by smelling a stranger’s T-shirt.

British researchers have found that a drug that has been used for years to treat cirrhosis and gallstones may slow the progression of Parkinson's disease. Employees of the Sheffield Institute of Translational Neuroscience (SITraN) and the University of York report on the interesting results of their work.

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Modern drugs for the treatment of Parkinson's disease

As a person ages, the risk of developing various diseases increases, including diseases associated with neurodegenerative processes. One such disease is Parkinson's disease. This condition is characterized by a disturbance in the patient’s motor sphere, a predominance of increased muscle tone, stiffness of movement and tremor. Timely diagnosis of the disease allows timely prescribing of effective treatment aimed at improving a person’s quality of life and eliminating neurological symptoms. Modern medications for Parkinson's disease should be prescribed only by the attending physician, after assessing all available indications and contraindications.

Effective therapy

There are no drugs that can completely stop PD.

Parkinson's disease, like parkinsonism, is characterized by a long-term, steadily progressive nature. Clinical manifestations are constantly increasing, which worsens the prognosis for the patient. Neurologists note that treatment should be comprehensive and be aimed at the following things:

• eliminating clinical manifestations that complicate the patient’s life or reducing their intensity;
• it is necessary to prevent the development of new neurological symptoms, as well as reduce the risk of progression of Parkinson’s disease from one stage to another;
• increasing the quality of life, especially in people in early old age.

Parkinson's disease is a significant problem for older people, leading to a decrease in their quality of life.

Existing methods of treating Parkinson's disease can be divided into several types, depending on the type of treatment used:

• use of medications;
• various methods of physiotherapy, physical therapy, massage, etc.;
• surgical interventions;
• methods of social rehabilitation.

Therapy for neurodegenerative diseases should always be comprehensive, since in addition to impaired neurological functions, the patient experiences depression and personality changes.

Medications

Drugs for the treatment of Parkinson's disease (in the form of tablets, capsules or drops) begin to be used in cases where existing neurological manifestations interfere with leading a normal lifestyle. This is very important to understand, since the initial occurrence of symptoms, such as increased muscle tone or mild tremors, is not an indication for the use of drugs.

The drug approach can either be symptomatic, i.e. eliminate existing clinical symptoms, or pathogenetic ones, influencing the mechanisms of development and progression of a neurodegenerative disease. When choosing medications for Parkinson's disease, it is important to take into account the person's age, any concomitant diseases he has, and the characteristics of the body. There are certain standards of therapy that can improve long-term results. However, in each specific case, it is the neurologist who must select a combination of drugs that can ensure the effectiveness of therapy in the patient.

When choosing medications, it is necessary to determine a dosage that reduces the severity of clinical symptoms or completely eliminates them, but at the same time has minimal negative effects on the body. This is very important, since the tablets used have significant side effects, the risk of which increases significantly even with a slight increase in dose. In rare cases, no changes in symptoms are observed during treatment. This situation is an indication for the use of various treatment regimens based on a combination of medications.

Drug treatment for Parkinson's disease is designed to alleviate the patient's condition and slow down the progression of the disease.

There are a number of medications that have a pronounced positive effect on the course of Parkinson’s disease:

• monoamine oxidase-B blockers;
• dopamine receptor stimulants;
• blockers of the action of choline and its analogues;
• levodopa and similar medications;
• amantadines;
• catechol-O-methyltransferase blockers.

The choice of how to treat Parkinson's disease is always made by a neurologist, since only he is able to correctly assess the existing manifestations of Parkinson's and the characteristics of the patient's body. Otherwise, the disease may progress rapidly, and the patient may experience side effects from the treatment.

Use of drugs

Medicines used for the treatment of Parkinson's disease and Parkinsonism syndrome are usually divided into the above pharmacological groups. Each of these groups has its own characteristics and rules of admission. It is important to note that, in accordance with the standards of care, patients with neurodegenerative diseases receive free treatment.

Amantadins

Drugs from the Amantadine group, for example, Amantin, Neomidantan, etc., improve the release of dopamine from neurons and suppress the processes of its uptake into the depot, which leads to an increase in the concentration of the neurotransmitter in synapses and reduces the severity of clinical manifestations in the patient. The usual dosage is 100 mg three times a day. However, the patient can take the medication in an individual dose, which is selected by the doctor.

When using Amantadines, various side effects may develop in the form of headache, dizziness of varying severity, nausea, increased anxiety, edema syndrome and changes in blood pressure.

B-type monoamine oxidase blockers

Drugs in this group, for example, Segan or Yumex, prevent the destruction of dopamine molecules, increasing its concentration in certain structures of the central nervous system. The drug is usually used twice a day, 5 mg. Side effects are rare, and there are practically no contraindications. Among the undesirable drug reactions of these drugs, dyspeptic disorders and a slight increase in insomnia are noted.

Dopamine receptor agonists

The use of dopamine receptor agonists (Cabergoline, Pronoran, Pergolide, etc.) is effective at various stages of Parkinson's disease. The molecules of these substances are able to independently stimulate dopamine receptors, improving brain function. Treatment begins with minimal dosages, gradually increasing them if there is no visible effect. The drug is well tolerated by people of all ages, including the elderly. If you take the drug for a long time without proper medical supervision, then mental disorders with the development of hallucinations, insomnia and other manifestations are possible.

Acetylcholine blockers

Effective drugs of this group, for example, Cyclodol and Akineton, quickly lead to a good therapeutic effect in the form of eliminating tremor in the patient. The mechanism of action is associated with their ability to change the acetylcholine-dopamine ratio in the structures of the central nervous system. At the beginning of therapy, the drug should be dosed in minimal quantities - 1 mg twice a day. If there is no effect, the dosage is gradually increased. It is important to note that abrupt withdrawal of these medications is prohibited due to severe withdrawal syndrome, characterized by a sharp reversal of symptoms of Parkinson's disease. Side effects vary, and are most often associated with a decrease in the activity of acetylcholine: disturbances in focusing vision, a slight increase in the pressure of the intraocular fluid, tachycardia, stool disorders, etc.

Levodopa

Levodopa is a well-known drug widely used to treat Parkinson's disease. It is converted into dopamine in the body's cells, thereby eliminating its deficiency. As a rule, it is used in complex therapy with benserazide and carbidopa. The last two drugs are classified as new generation drugs that allow achieving a lasting clinical effect with minimal dosages. This is good news for those patients who develop side effects at starting doses of medications.

Carbidopa increases the amount of levodopa entering the brain

COMT inhibitors

Catechol-O-methyltransferase (COMT) blockers - Comtan and other similar agents, lead to an improvement in the action of Levodopa and its analogues. Due to the frequent combination of these drugs, there is a commercial combination medicine - Stalevo.

Despite the high clinical effectiveness of Levodopa, they try to use this drug in the later stages of the disease. Levodopa leads to an increase in the amount of dopamine, which can cause a decrease in the sensitivity of receptors to this neurotransmitter - this can aggravate existing clinical manifestations. Levodopa should be used in the treatment regimen in cases where other medications do not have a pronounced effect.

Long-term use of Levodopa and its analogues can cause the appearance of drug dyskinesias - clinical conditions manifested by the occurrence of involuntary movements of the limbs. It is important to note that this medication must be discontinued gradually, as otherwise a withdrawal syndrome occurs, characterized by an intensification of previously existing symptoms.

Treatment approaches

It is impossible to cure Parkinson's disease completely, however, it is possible to reduce the intensity of clinical manifestations and prevent their progression in the future. In this case, the treatment process depends on when the disease was identified and at what stage of development it is.

The combined use of drugs allows you to achieve a good therapeutic effect with minimal risk of side effects.

When prescribing therapy in the initial stages of Parkinson's disease, it is recommended to use amantadines, MAO-B blockers and dopamine receptor stimulators. Treatment begins with one medication, gradually adding new drugs if monotherapy is ineffective. The prospects for the patient with early use of medications are good - the progression of the disease can be significantly slowed down, significantly increasing the person’s quality of life.

The selection of medications for the treatment of PD depends on the stage of the disease

When carrying out treatment in the later stages of the disease, Levodopa and its analogues come first, which have a pronounced therapeutic effect in patients of any age. It is important to note that treatment should begin with minimal dosages of medications, gradually increasing them under medical supervision.

Parkinson's disease is a continuously progressive neurodegenerative disease that leads to severe neurological manifestations and decreased quality of life. This condition requires early diagnosis and drug treatment to improve the prognosis for the patient’s future condition. Proper selection of medications allows you to achieve the disappearance of symptoms and prevent their further progression.

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A new drug is being developed in Russia to treat Parkinson's disease

Parkinson's disease is a disease of the central nervous system, which tends to develop and become chronic over time. The disease is degenerative and causes the death of neurons that produce the neurotransmitter dopamine, which is necessary for full brain activity. Due to a lack of dopamine in the body, muscle rigidity, tremors, insufficient activity of the musculoskeletal system and instability of the patient in one position occur.

Parkinson's disease is currently an incurable disease. Existing drugs and therapeutic methods can only stop the development of the disease and slightly improve the patient’s well-being, but do not provide a complete cure.

Specialists from the Tomsk company “Innovative Pharmacological Developments”, along with the Novosibirsk Institute of Organic Chemistry SB RAS, have developed an innovative drug that in the future will make it possible to effectively cope with Parkinson’s disease. The drug is undergoing preclinical trials, and its trial administration to people suffering from parkinsonism is planned for 2016.

Scientists believe that this medication will be much more effective than all existing analogues on the market, since, in their opinion, not all drugs for Parkinson’s disease help in treating this disease, often they even worsen the symptoms of the disease. The newest vaccine was created only on the basis of natural ingredients and the turpentine component of pine resin, which is useful in the fight against parkinsonism.

The medicine will be produced in the form of tablets, the administration of which will be much more convenient for patients with parkinsonism who are not able to independently give themselves an injection with the necessary vaccine due to disorders of the musculoskeletal system.

If clinical and preclinical studies are successful, the drug will be able to enter the market within a few years.

All information provided on this site is for reference only and does not constitute a call to action. If you notice any symptoms, you should immediately consult a doctor. Do not self-medicate or self-diagnose.

Quickly and without surgery: the latest methods for treating Parkinson's disease

Modern treatments for Parkinson's disease are aimed at stimulating the affected areas of the brain. A technique for deep stimulation and ultrasound therapy has been developed, which gives excellent results.

Parkinson's disease is a chronic progressive disease of the nervous system. The disease is characterized by the death of nerve cells that play an important role in a person’s voluntary movements. This leads to the appearance of such motor disorders as tremor, muscle rigidity, hypokinesia and postural instability.

According to medical statistics, the incidence rate of Parkinson's disease ranges from 55 to 130 patients per 100 thousand population. As a rule, these are people over 60 years of age, although the disease also occurs in young people.

How is Parkinson's disease treated?

Both medical and surgical methods are used in the treatment of Parkinson's disease. Drug therapy for the disease involves the use of levodopa-based drugs. These drugs are quite effective, but lead to many side effects, so scientists and doctors are trying to find new, safer and no less effective ways to treat this disease. Fortunately, specialists have achieved significant success in this direction. Today, doctors have the latest methods of treating this disease: deep brain stimulation and ultrasound therapy.

Deep brain stimulation for Parkinson's disease

Deep brain stimulation is a modern method of treating Parkinson's disease and epilepsy. This treatment is effective even in severe forms of the disease.

The deep brain stimulation procedure is a minimally invasive operation in which a special electrode is implanted into the patient's brain to stimulate its activity. It is noteworthy that modern endoscopic technologies make it possible to perform such an operation without incisions. The electrode is delivered to the brain through the nasal passages. This operation requires high precision and skill of the surgeon.

Treatment of Parkinson's disease with ultrasound

Not long ago, a real revolution took place in the world of medicine. Israeli scientists have learned to treat Parkinson's disease using ultrasound. This method does not involve any invasive interventions. For treatment, ultrasonic waves are used, which are directed to the pathological focus. This is the world's first technology that affects affected areas of tissue without damaging healthy areas of the brain. This treatment method was recently tested in the USA, where it showed impressive results. According to the results of clinical studies, the functional activity of patients with Parkinson's disease during ultrasound treatment increased by as much as 90%!

Treatment of Parkinson's disease with ultrasound occurs as follows. The patient is placed in the tunnel of the MRI machine. The patient is fully conscious, and a special helmet with ultrasonic emitters is put on his head. Using an MRI machine, the doctor determines the exact location of pathological lesions in the brain. The doctor then remotely activates the ultrasonic emitters on the helmet. The waves penetrate deep into the brain, affecting areas that are responsible for tremors and other manifestations of Parkinson's disease.

When carrying out such treatment, every 5-10 minutes the doctor communicates with the patient, asking him questions regarding the patient’s well-being. It is noteworthy that improvements after such treatment occur instantly. And after the procedure is completed, it is often possible to achieve a stable effect.

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Drugs for Parkinson's disease

Parkinson's disease is one of the few progressive neurological diseases of a chronic course, which are characterized by degenerative changes in the extrapyramidal motor system. The disease mainly affects older people, particularly men. Despite advances in modern pharmacology and medicine, there is no medicine or method that can completely cure the disease. But there are still drugs for Parkinson’s disease, the mechanism of action of which is aimed at slowing the progression of the pathology and improving the quality of life of patients.

During the development of the disease, the neurons of the central nervous system that produce the neurotransmitter dopamine die. A deficiency in dopamine production leads to disruption of brain function, with the subsequent development of muscle rigidity, hypokinesia, tremor and other clinical symptoms.

How do antiparkinsonian drugs work?

Drug therapy consists of taking antiparkinsonian drugs, which replenish the dopamine deficiency due to the death of brain cells. An integral part of treatment is considered to be pills for Parkinson's disease, which help slow down the progression of the pathology - neuroprotective therapy.

Taking vitamins and antioxidants is considered an auxiliary remedy; doctors also prescribe symptomatic therapy, which includes taking medications that eliminate the general symptoms that are present in this disease.

Important! The choice of any drug, as well as the dose and course of treatment, is prescribed individually by the attending physician.

Levodopa drugs are considered basic in treatment for Parkinson's disease. They are prescribed to all patients. As a rule, other medications are also prescribed, but they are taken in combination with Levodopa. Drug treatment performs two main tasks:

1. Reduces the rate of death of brain cells with dopamine.
2. Reduces symptoms, thereby prolonging the patient’s life.

Basic therapy

Antiparkinsonian treatment consists of taking the following groups of medications:

1. Levodopa: Stalevo, Nacom – converts levodopa into dopamine.
2. Agonists: Pramipexole, Dostinex - stimulate dopamine receptors in brain cells.
3. Amantadines: Viregit, PC-Merz - increase the production of dopamine in brain cells.
4. Monoamine oxidase type inhibitors: Segiline, Azilect - prevent the process of destruction of dopamine.
5. Anticholinergic drugs: Cyclodol - normalize the biochemical imbalance in the cells of the nervous system, which appears against the background of a lack of dopamine.
6. Vitamins of group B, C and E. They have a pronounced antioxidant effect in the fight against free radicals.
7. Vitamins for Parkinson's disease allow you to provide the human body with all the necessary substances to improve the functioning of the central nervous system.

The doctor may prescribe other medications, since the range of antiparkinsonian drugs is quite extensive. In the past few years, doctors have frequently prescribed new drugs for Parkinson's disease. These medications will also not be able to cure the disease, but are well tolerated and have successfully passed a number of clinical trials, during which it has been proven that their use reduces the symptoms of delusional states and reduces tremors. These drugs include a new drug for Parkinson's disease - Nuplazid (Pimavanserin). It comes in the form of tablets for oral use.

Drug Review

The pharmacological market offers a number of medications for treatment, but only a doctor can prescribe them, based on the stage of the disease, the patient’s age, and the characteristics of his body.

1. Levodopa is a medication that increases dopamine levels. Taking this medicine relieves all symptoms.
2. Selegiline is an MAO B inhibitor that helps reduce signs of the disease, thereby slowing down disability.
3. Propranolol - reduces tremor and has a pronounced sedative effect.
4. Amitriptyline is a sedative drug that helps reduce irritability and increased excitability in patients
5. Parkinson.
6. PC-Merz.
7. Midantan.
8. Mirapex.
9. Pramipexole.
10. Rasagiline.

Any of the above drugs has a number of contraindications and side effects, so they should be taken strictly as prescribed by the doctor individually for each patient.

Features of application

Parkinson's disease cannot be completely cured, but still, if therapy is carried out correctly, there is every chance to improve the patient's general well-being and increase life expectancy. During the treatment process, patient care is considered important, as well as compliance with all recommendations given by the doctor. Uncontrolled use of any medication can harm the patient’s health and aggravate the course of the disease.

I’m 62 years old, I have Parkinson’s disease, heart disease, what pills to take so that they don’t cause arrhythmia attacks

You should ask your doctor this question. Drugs are prescribed taking into account concomitant diseases after examination.

Shoshina Vera Nikolaevna

Therapist, education: Northern Medical University. Work experience 10 years.

Articles written

Parkinson's disease, as a particular form of parkinsonism, is still somewhat of a mystery. It is the second most common neurodegenerative disorder. Until now, the disease has not been fully cured, but surgical techniques and high-quality pills for Parkinson’s make it possible to delay the destructive effect of this complex pathology as much as possible in time.

Approaches to the treatment of Parkinson's disease

The disease has been known to mankind for many centuries, but it has not been studied and systematized. The characteristic signs of the disease in the form of tremor, specific gait and muscle rigidity were described by many ancient authors, including Galen. The disease gets its name from James Parkinson, an English physician who wrote An Essay on the Shaking Palsy in 1817. But full-fledged research began only at the end of the 19th – beginning of the 20th century.

In the middle of the last century, the role of dysfunction of the neurotransmitter dopamine in the development of the disease was revealed. The discovery influenced treatment methods. The first method was the use of belladonna alkaloids (atropine), which was used at the turn of the century before last. At the end of the 30s of the twentieth century, they learned to perform operations to destroy the basal ganglia, which brought tangible results.

Over the course of several decades, surgical treatment methods have been developed and constantly improved, but they remained the only effective means of combating the disease, other than the use of anticholinergic drugs. Their work was aimed at blocking acetylcholine, a natural neurotransmitter.

At the very end of the 20th century, encouraging attempts were made to treat using electrical stimulation of deep brain structures with impulses. These techniques were considered worthy of attention and further study for use.

But before the invention of a drug called Levodopa, drug treatment for Parkinson's disease was almost a hopeless endeavor.

Drugs in the initial stages of the disease

If a patient is diagnosed with Parkinson's disease, treatment should begin as early as possible. Although the disease is currently considered incurable, early use of specialized medications helps to delay the appearance of negative signs as much as possible.

Levodopa has been considered the most common in recent years. But this effective remedy has a fairly large number of side effects, in particular, with long-term use of significant doses, the patient develops difficult-to-treat motor impairments.

Because of this, when deciding how to treat progressive Parkinson’s disease, many doctors prefer to use modern alternative drugs, for example, dopamine antagonists - Ropinirole, Pergolide, Apomorphine, Pramipexole and others.

If the patient is given these drugs at the first signs of shaking paralysis, then the use of Levodopa can be postponed to a later period, therefore, reducing the risk of developing motor disorders. However, dopamine agonist drugs themselves can lead to the same changes.

If the patient is over 70 years old, then the restriction on the use of Levodopa does not apply to him.

For use in the early stages of the disease, monotherapy is more suitable, that is, the use of one specialized drug to avoid the rapid development of side effects.

Medications in later stages

Drugs for progressive Parkinson's disease can also be used in monotherapy, but combination therapy is more often used:

• Levodopa is the main medicine at the moment.
• "Amantadine", which has an effect against Parkinson's disease and stimulates the production of dopamine.
• "Stalevo" and its analogues, which enhance the effectiveness of "Levodopa" and prolong its action.
• MAO-B inhibitors, for example, Rasagiline, which increases the concentration of dopamine and prevents its breakdown.
• Dopamine receptor agonists.
• Cholinotropic drugs.

Drug treatment is complemented by physiotherapeutic procedures, exercise therapy, classes with a speech therapist aimed at correcting speech and swallowing disorders, and psychotherapy for social rehabilitation.

Additionally, symptomatic and supportive medications are used to treat associated symptoms, for example, the essential amino acid phenylalanine. It is capable of being converted into tyrosine in the patient’s body, which is involved in the synthesis of dopamine.

A neurostimulator is also used for older people when they take Levodopa, but the body responds poorly to treatment. In this case, stimulation of deep brain structures is used with the destruction of some subcortical nuclei. This causes a significant improvement in the patient’s condition, a retreat of severe symptoms, and an increase in the person’s socialization. The doctor can reduce the dosage of drugs for Parkinson's, which will reduce negative symptoms and make the patient's life easier.

Using a stimulator is much simpler and safer than using electrodes in classical forms of intervention. The operation takes less time and only one small hole is made in the skull. An antiseptic is used for treatment, and an antimicrobial drug is given to prevent infection. There is always a risk, but with such jewelry surgery it is minimal. The only obstacle is the high cost of the operation.

The use of a neurostimulator does not exclude the use of other treatment methods, including medications, and the most advanced techniques that are under development - genetic engineering and stem cell therapy, the use of special viruses, impulse stimulation of neurons. The patient must be aware that improvement in condition does not mean complete recovery, that he still needs to be treated and monitor his health.

Side effects of treatment

Since the main treatments for Parkinson's disease are drugs that restore dopamine levels, side effects are mainly caused by the use of Levodopa and other drugs with similar effects.

The tablets have an excellent effect on severe tremors, muscle rigidity and limited mobility, which causes real euphoria in many patients at the beginning of use. However, this remedy has virtually no effect on balance disorders and gait stiffness.

Moreover, long-term use of Levodopa or its high doses lead to the development or intensification of dyskinesias - sudden involuntary and uncontrolled movements, twitching, twisting of limbs. Anticonvulsants in such cases are useless or ineffective.

Levodopa can cause many negative symptoms. These include the following:

• nausea;
• vomit;
• constipation;
• hypotension;
• high nervous excitability, irritability.

Because of this, doctors prefer not to prescribe Levodopa in the initial stages of the disease, but to make do with other drugs that increase dopamine levels. The same is used if this particular medicine is contraindicated for the patient.

Possible reasons for decreased effectiveness of therapy

As Parkinson's disease progresses, prescribed pill treatment may become less effective over time. The disease increasingly affects the body, less dopamine is produced, and the drugs used do not cope with the situation.

Due to the large number of side effects and a decrease in the effectiveness of treatment with one drug, in recent years, Levodopa in its pure form is rarely used. Most often, its combination with dopadecarboxylase inhibitors is used for therapy. These are drugs such as “Nakom”, “Madopar” or their substitutes.

“Midantan” (amantadine) and its analogues are also used: “Viregit”, “Symmetrel”, dopamine receptor stimulants - “Parlodel”, “Mirapex”, “Apomorphine” and others.
In the treatment of Parkinson's disease, not only the use of pills and surgery, but also lifestyle changes play an important role. The patient needs to eat properly to avoid the side effects of medications, give preference to vitamin-rich foods, and reduce protein intake in the morning.

They play an important role in helping to restore limb mobility and strengthen muscles. There is also a free method - walking and a positive attitude, which depends on the support of the patient from family and friends.

Symptomatic therapy includes the use of painkillers for painful movements, sleeping pills for sleep disorders, sedatives for high excitability and aggressiveness, irritability, and depression.

There are no trifles in the treatment of Parkinson's disease, since it affects the main organ - the human brain. To improve your health, it is important to maintain a good vascular system.

It is not yet possible to cure the disease, but with the use of all the achievements of modern medicine and complex effects, it is possible to prolong the patient’s life and improve its quality.