Treating Parkinson’s Disease

Parkinson’s disease is a brain disorder that affects movement. It can cause shaking (tremors), stiffness and slow movement. While there’s no cure, treatment can reduce symptoms and improve your quality of life.

At Banner Health, we personalize care to fit your needs, combining medications, therapies and healthy habits for the best possible outcomes.

What are the goals of Parkinson’s disease treatment?

Treatment for Parkinson’s disease focuses on helping you:

• Manage motor symptoms like tremors and stiffness
• Stay active and independent
• Improve how you feel day to day
• Minimize medication side effects
• Support your emotional and mental health

What medications are used to treat Parkinson’s disease?

Medications are a key part of treating Parkinson’s disease. While there is no cure, medication can help you feel better and stay active. Some medications improve movement problems, while others help with non-movement symptoms like depression and memory issues.

Your treatment plan may include one or more types of medication. It often takes time to find the right mix that works best for you. Your health care team will adjust your medications based on how your symptoms change over time.

What medications help with Parkinson’s movement symptoms?

Dopamine is a chemical that helps control movement, but people with Parkinson’s don’t make enough of it naturally. Most Parkinson’s medications increase dopamine in the brain or help your brain use it more effectively. 

• Levodopa/carbidopa (Sinemet®, Crexont®, Rytary®, Dhivy®): This is the most commonly used treatment for Parkinson’s. Levodopa converts to dopamine in the brain. Carbidopa helps levodopa work better and reduces side effects like nausea and vomiting. 
• Dopamine agonists (pramipexole, ropinirole, Neupro® patch): These drugs act like dopamine in the brain. They are often used early in the disease or along with levodopa later on. Mirapex and Requip come in pill form. Neupro is a patch you wear on your skin once a day.
• Enzyme inhibitors (MAO-B and COMT inhibitors): These medications help dopamine last longer in the brain by blocking the enzymes that break it down. They are often used along with levodopa to improve its effects. MAO-B inhibitors are Azilect® (rasagiline), Xadago® and selegiline. COMT inhibitors include entacapone and Ongentys®.   
• Amantadine (Gocovri®): This medication reduces dyskinesia (jerky movements) that can happen after using levodopa for many years.
• Anticholinergics (trihexyphenidyl, benztropine): These medications help with tremors, especially in younger people with Parkinson’s. However, they are used less often due to side effects like memory problems or confusion.

Your health care team will work closely with you to find the right mix of medications and adjust them over time. Everyone responds to medication differently and your needs may change as the disease progresses. 

How is Parkinson’s disease treated for non-motor symptoms?

Parkinson’s also affects sleep, mood, thinking, digestion and more. Your care team may recommend other medications to manage these symptoms:

• Sleep problems: Medications like melatonin or certain sedatives may be recommended by your clinician to calm acting out of dreams while asleep.
• Mood changes: Antidepressants and anti-anxiety medications may be used to treat depression, anxiety and mood swings.
• Memory and thinking issues: Some medications used for Alzheimer’s disease, such as donepezil or rivastigmine, may be prescribed to help with thinking and memory problems in Parkinson’s.
• Digestive issues: Laxatives, stool softeners or medications that help move food through the stomach may be needed to manage constipation or slow digestion.
• Blood pressure: If Parkinson’s causes sudden drops in blood pressure when standing (orthostatic hypotension), your provider may prescribe medication to help keep your blood pressure steady.
• Bladder problems: Medications can help reduce urgency, frequency and incontinence. 
• Hallucinations or delusions: Only Nuplazid (pimavanserin) is FDA approved for Parkinson’s psychosis but Seroquel (quetiapine) or clozapine may be used.  Other antipsychotics like olanzapine, aripiprazole, risperidone, or haloperidol are sometimes mistakenly prescribed but can worsen motor symptoms of Parkinson’s disease.

Talk to your health care provider about changes in how you feel. Many non-motor symptoms can be managed with the right treatment plan.

What therapies help manage Parkinson’s disease?

Different therapies can help improve how you move, talk and function day to day.

• Physical therapy: Physical therapy helps improve strength, balance, posture and walking. A physical therapist can also teach exercises to help you stay safe and reduce fall risk.
• Occupational therapy: Occupational therapy helps you do everyday tasks like eating or dressing. Therapists may suggest ways to change your home or use special tools to make things easier. 
• Speech therapy: Parkinson’s disease can affect your voice and how you swallow. A speech therapist can help you speak more clearly and teach safe ways to eat and drink.
• Counseling and mental health therapy: Some people with Parkinson’s feel depressed, anxious or have trouble with memory or thinking. Talking with a therapist or counselor can help with these changes and improve your mental health. 
• Infusion therapies for Parkinson’s: When carbidopa/levodopa is not lasting long enough or working reliably, intestinal carbidopa/levodopa (Duopa™), subcutaneous foscarbidopa/foslevodopa (Vyalev™), or subcutaneous dopamine agonist apomorphine (Onapgo™) can provide more consistent and predictable delivery of medication. These therapies can result in more “on” time (periods when symptoms are controlled). 
• Deep brain stimulation (DBS) for Parkinson’s: If medications stop working well or cause too many side effects, deep brain stimulation may help. It is the most common surgery for Parkinson’s. A small device is placed in the brain to send signals that help control movement. DBS can reduce shaking and stiffness but doesn’t stop the disease. DBS is not for everyone. Talk to your provider about whether you are a good candidate for the device.

Living with Parkinson’s means more than just treating symptoms. Get tips for daily living and support resources.

What complementary therapies are available for Parkinson’s disease?

Mood changes are common. Support groups, staying connected to friends and seeing a therapist can help you cope with changes and feel more in control.

Some people also find benefit in:

• Massage
• Acupuncture
• Art and music therapy 
• Meditation and deep breathing exercises

These should be used in addition to, not instead of, medical treatment.

What lifestyle changes help with Parkinson’s disease?

Lifestyle changes can help you feel better and stay active. These changes work best when combined with medical treatment. 

• Exercise: Staying active helps with balance, strength and mood. Try walking, swimming, yoga or biking. Regular exercise also helps reduce stiffness and improves how you move.
• Healthy eating: A good diet supports your brain and body. Some people find it helpful to meet with a registered dietitian. They can advise on how to eat well, manage weight and time meals with medications.
• Better sleep: Some people with Parkinson’s disease have trouble sleeping. Good sleep habits, like going to bed at the same time each night and avoiding screens before bed, can help.

Clinical trials for Parkinson’s disease

Explore new treatment possibilities through clinical trials currently enrolling at Banner Health. These trials give you access to the latest therapies and advancements in care.

Explore Parkinson’s disease treatment at Banner Health 

Our experienced neurology team creates personalized care plans that evolve with your needs. We work with you to find the best treatment options for movement and non-movement challenges to help you live a fuller life.

Explore ways to live well with Parkinson’s every day. Visit our guide for daily living tips and support resources.

Find a Banner Health Parkinson’s specialist and explore your treatment options today.