Treatment for Late-Stage Parkinson’s Disease Not Adequate

By Lauren Thayer from In The Cloud Copy

Parkinson’s disease is a neurodegenerative disorder that is progressive, resulting in the patient having problems with movement. The symptoms of Parkinson’s disease are caused by a drop of dopamine in the brain due to nerve cell damage. Symptoms of the disease tend to develop gradually over several years, but the progression is variable as the disease varies from person to person.

Early signs of Parkinson’s disease are usually a tremor in one hand or one side of the body.  In the early stages, the symptoms appear mild and don’t interfere too much with a person’s everyday activities. As the disease progresses, symptoms become more intense with rigidity, walking problems, loss of balance, tremors affecting both sides of the body, stiffness, and more.

There are five stages of the disease, with symptoms progressing more in each stage. An individual with stage five Parkinson’s disease is typically bedridden or requires a wheelchair and around the clock care for all activities.

In addition to motor symptoms so commonly associated with Parkinson’s disease, there are many non-motor symptoms that patients may experience.  These include, but are not limited to, symptoms such as constipation, fatigue, hallucinations and delusions, sleep disorders, pain, mood disorders, and more.

Treatment of Parkinson’s Disease

While there is currently not a cure for Parkinson’s disease, there are many medications and other treatments available to help with symptom management and to improve the patient’s quality of life.

The most common drug used in treatment is levodopa. This medication is converted to dopamine in the brain cells. Since individuals with Parkinson’s don’t have sufficient dopamine, this drug helps to supplement and ultimately helps the individual control their movements.

Carbidopa is another medication often prescribed in combination with levodopa. Carbidopa helps the levodopa to work better, so that you can take less of the levodopa and ultimately experience less of the debilitating side effects of levodopa.

When medications fail to control symptoms, there are also surgical treatments that patients can look to.

Treatments for Late-Stage Disease

While treatments for Parkinson’s patients seem adequate in early stages of the disease, a recent study “The late stage of Parkinson’s – results of a large multinational study on motor and non-motor complications” found that patients with late-stage disease cannot maintain adequate control of their symptoms with current treatments.

It was found that treatment with levodopa, the most commonly prescribed treatment, loses its effect over time and patients experience a great increase in “off periods” or times in which their symptoms are not controlled. In patients with a disease duration of greater than 10 years, 90% of them report experiencing off periods, compared to only 40% of those with a diagnosis within 4 to 6 years.

The most common symptom that patients reported was falls, which can be incredibly dangerous to patients.  Other symptoms patients experienced included difficulty turning in the bed, tremors, and difficulty with swallowing and/or speech.

Levodopa-induced dyskinesia is another side effect of long-term levodopa use that is experienced by those with late-stage disease.  This results in involuntary movements ranging from moderate to severe.

While treatment in early stage disease seems to be effective in controlling life limiting symptoms, it’s clear that late stage disease remains widely uncontrolled and disabling symptoms are still present in patients.

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