Parkinson’s Disease is a progressive neurological condition, which causes a loss of dopaminergic neurons in the brain and leads to a loss of dopamine production. The body uses dopamine to help coordinate movement, which is why PD often causes physical symptoms like shaking (tremor), rigidity (dystonia) and difficulty walking. PD also causes non-motor symptoms like sleep disturbances, anxiety, depression, hallucinations, and/or cognitive issues. PD is the second most common age-related neurodegenerative disorder after Alzheimer’s disease.
There is currently no cure (yet) for Parkinson’s disease. However, current treatments for PD help improve and control symptoms. Each occurrence of PD is different, so it is difficult to determine how your PD will progress. Please ask you doctor for more detail about disease progression.
Levodopa: Doctors have been treating PD with Levodopa for the past 50 years. As the brain loses the ability to create and convert dopamine in the brain, symptoms worsen. Lovodopa helps replace the dopamine that is no longer produced because of PD. Commonly, you will see carbidopa combined with levodopa, to help minimize side effects.
Common pill forms include: Sinemet, Rytary, CD/LD
Intestinal Infusion: Duodopa
Dopamine Agonists: Is often used before the use of Levodopa, to treat motor symptoms of PD; though dopamine agonists can also be used in combination with Levodopa. Dopamin agonists are designed to act like dopamine, stimulating dopamine receptors in the brain.
Common pill forms include: Pramapexole, ropinirole Injectables: Apomorphine
Monoamine Oxidanse B (MAOB) Inhibitors: Help to keep dopamine in the brain longer, by blocking enzymes known as MAOB, which break down dopamine in the brain.
Common MAOB Inhibitors include: Rasagiline (Azilec) and Selegiline
Deep Brain Stimulation (DBS): Is used to control PD symptoms when oral medications stop working or become significantly less affective. DBS is a surgical prcedure that places electrodes (electrical stimulation to the brain). The electrodes use high frequency stimulation on the parts of the brain that help control PD symptoms.
- Catechol-O-Methyl Transferase (COMT) Inhibitors: Help extend the length of time levodopa works in the brain. COMT inhibitors block enzymes that break down levodopa, so the effects of levodopa last longer on control PD symptoms.
Common pill form of COMT: Entacapone, Opicapone, and Stalevo
This means you medication (like CD/LD, Rytary etc.) are wearing off and your symptoms are starting to return, like:
- Tremors, trembling of hands, arms, legs, jaw and face
- Stiffness of the arms, legs and trunk
- Slowness of movement
- Poor balance and coordination
- Speech difficulty
This means it might be time for your next dose, or to talk to your doctor about increasing or changing you dose or medications. Often “off” times occur in the morning, between doses, if you are under stress, or having much physical activity.
When you take your dose of drug and you start to notice your PD symptoms less or stop all together. The effects of your drug regimen may vary. Talk to your doctor about how to maximize the “on” effects of your PD medications.
AbbVie M12-927 INSIGHTS: A 26-week study comparing Levodopa-Carbidopa gel therapy to improve medical treatment of non-motor symptoms in people with advanced Parkinson’s Disease.
AbbVie P14-494: DUOdopa/Duopa in Patients with Advanced Parkinson’s Disease (PD) – a GLobal OBservational Study Evaluating Long-Term Effectiveness (DUOGLOBE); with PMOS DUOGLOBE KinetiGraph™
AbbVie H17-224: Evaluation of oral anti-parkinsonian medication use in patients with advanced Parkinson’s disease with history of Deep Brain Stimulation (DBS) and being treated with Carbidopa Levodopa Enteral Suspension (CLES)
AbbVie M15-741: Parkinson’s Disease: Safety and Tolerability of 24-Hour Daily Exposure to ABBV-951 by Continuous Subcutaneous Infusion
Abbott ABT-CIP-10245: EVIDENT – Evaluation of the Infinity Deep Brain Stimulation Electrode Screening Mode Tool
Abbot ABT-CIP-10262: INFINITY MRI – A Post-Market Study Evaluating the Safety of Infinity DBS System with MR Conditional Labeling
Acadia ACP-103-056: A Pilot Randomized, Double-blind, Placebo-controlled Study to Evaluate Safety and Daytime Sedation in Subjects
Biogen SPARK 228PD201 (Parkinson’s Study Group): A phase 2A study of the safety, pharmacokinetics, and pharmacodynamics of BIIB054 in people with Parkinson’s Disease who’ve been diagnosed for a maximum of 3 years.
Biogen 254PD101: A Phase 1 Single- and Multiple-Ascending-Dose Study to Assess the Safety, Tolerability, and Pharmacokinetics of BIIB094 Administered Intrathecally to Adults With Parkinson’s Disease
Boston Scientific Neuromodulation Corp A4069: Registry of Deep Brain Stimulation with the VERCISE™ System
Denali Therapeutics Inc. DNLI-B-0002: A Phase 1b, Multicenter, Randomized, Placebo-Controlled, Double-Blind Study To Determine The Safety, Tolerability, Pharmacokinetics, And Pharmacodynamics Of DNL201 In Subjects With Parkinson’s Disease (Pro00035070)
Impax Labs IPX203-B16-02: A Randomized Controlled Study To Compare The Safety And Efficacy Of IPX203 With Immediate-Release Carbidopa-Levodopa In Parkinson’s Disease Patients With Motor Fluctuations
Impax Labs IPX203-B16-03: An Open-Label Extension Study of the Safety and Clinical Utility of IPX203 in Parkinson’s Disease Patients with Motor Fluctuations
NeuroDerm ND0612H-012 (BeyoND): A study of ND0612 solution of levodopa/carbidopa given with a pump system infusion in people with advanced Parkinson’s Disease.
NILO-PD by Northwestern University (Parkinson’s Study Group): A phase 2A to test the safety, tolerability, and clinical and exploratory biological activity of treatment with nilotinib (NILO) in people with late-stage Parkinson’s Disease.
Revance 1820203: A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Parallel Group, Dose-Ranging, Multi-Center Trial to Evaluate the Efficacy and Safety of DaxibotulinumtoxinA for Injection for the Treatment of Upper Limb Spasticity in Adults After Stroke or Traumatic Brain Injury (JUNIPER)
SURE-PD (Parkinson’s Study Group, National Institute of Neurological Disorders and Stroke): A randomized, double-blind, placebo-controlled trial of urate-elevating inosine treatment to slow clinical decline in early Parkinson’s disease — *With optional study of Additional DaTscanTM imaging
Sunovion SEP361-203: A Multicenter, Randomized, Double-blind followed by an Open-label Extension Study to Evaluate the Efficacy, Safety, and Tolerability of SEP-363856 in Subjects with Parkinson’s Disease Psychosis
Theravance MARIN 0169: A Phase 3, 4-week, Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group Study of TD-9855 in Treating Symptomatic Neurogenic Orthostatic Hypotension in Subjects With Primary Autonomic Failure
Theravance REDWOOD 170: A Phase 3, 22-week, Multi-center, Randomized Withdrawal Study of TD9855 in Treating Symptomatic Neurogenic Orthostatic Hypotension in Subjects with Primary Autonomic Failure