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Summary DRUGS FOR PARKINSONS
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provides the main drugs used for treatment for Parkinsons
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DRUGS FOR PARKINSONS1. LEVODOPA
Considered first-line therapy for Parkinson’s.
Levodopa is a precursor to dopamine and is crosses the blood brain
barrier and is converted to dopamine in the brain.
Levodopa can be combined with carbidopa which is a DOPA
carboxylase inhibitor which allows more levodopa to reach the brain.
SIDE EFFECTS: nausea, vomiting, dyskinesias, fluctuations in
response.
2. DOPAMINE AGONISTS: PRAMIPEXOLE, ROPINIROLE
Primarily bind to D2/D3 receptors in the brain to mimic the action of
dopamine.
Pramipexole primarily helps improve motor symptoms and reduces
frequency of “off” periods.
Ropinirole is effective in reducing tremors, muscle stiffness and
slowness of movement.
Dopamine agonists are prescribed in early stages of Parkinson’s and
can be used alongside Levodopa to enhance its effects.
SIDE EFFECTS: nausea, vomiting, dizziness, sleep disturbances
3. MAO-B INHIBITORS: RASAGILINE, SELEGILINE
Inhibit MAO-B which prevents breakdown of dopamine thus elevating
dopamine levels in the brain.
Selegiline has additional benefit of metabolizing into amphetamine-like
compounds which have additional improvements.
MAO-B inhibitors improve motor fluctuations and can potentially
provide neuroprotective effects by preserving dopamine-producing
neurons.
Can be used with levodopa.
SIDE EFFECTS: nausea, G.I disturbances, headache, dizziness
4. COMT INHIBITORS: ENTACAPONE, OPICAPONE
Prevents breakdown of levodopa in peripheral tissues allowing more
Levodopa to reach the brain.
Entacapone prolongs action of Levodopa in brain, reducing “off”
periods and improving motor control.
SIDE EFFECTS: nausea, vomiting, diarrhea/constipation, dizziness.
5. AMANTADINE
Exact mechanism of action is not fully understood but believed to
increase release of dopamine in brain and blocks action of glutamate
which is an excitatory neurotransmitter.
SIDE EFFECTS: dizziness, dry mouth, insomnia.
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