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Parkinson's Disease

Current Treatments for Parkinson's Disease

Summary & Participants

Medications for Parkinson's disease can be effective, but they sometimes wear off too soon. Discover what's being done to allow patients to get longer responses to their treatment.

Medically Reviewed On: June 12, 2008

Webcast Transcript

ANNOUNCER: Research soon discovered another enzyme was also contributing to levodopa's loss of effectiveness.

C. WARREN OLANOW, MD: It turns out that there is another enzyme, which is called COMT, and this COMT now degrades levodopa, thereby reducing the availability of levodopa to the brain.

When we block the COMT enzyme, it increases the half-life of levodopa by preventing its breakdown, and thereby extends its availability to the brain. So we have speculated that if you could give levodopa in combination with an agent that blocks COMT then you might be able to deliver the levodopa to the brain in a more continuous and more normal manner.

WILLIAM KOLLER, MD: There's a recent drug that's been released in the United States and throughout the world, and it's a combination of the carbidopa, levodopa, and what we referred to as the COMT-inhibitors. It's been placed in one pill. And the advantage of having it in one pill is that you get two drugs that inhibit the enzymes for levodopa. So the levodopa stays in the blood longer, and you get a much longer clinical response.

ANNOUNCER: Aside from the problem of treatments wearing off, the problem of medication side effects may occur. These can result in other motor problems.

C. WARREN OLANOW, MD: The other motor complication is dyskinesia. Here patients can experience wild, involuntary flinging movements that can themselves be a problem, and they cycle between these states throughout the day, experiencing inadequate periods of time in which they're just plain well controlled without dyskinesia.

Now, the recognition that patients suffer from these problems led to an attempt to develop other drugs that might provide benefit with a reduced risk of experiencing or inducing these problems. One class of drug that we use is called dopamine agonists.

What dopamine agonists do is they go directly to the brain, and they act directly on dopamine receptors to try and simulate the effect of dopamine.

WILLIAM KOLLER, MD: They have the advantage that they cause less long-term complications, such as wiggly movements and loss of an effect. Their disadvantages is they're not as good at controlling the symptoms as levodopa-containing compounds.

ANNOUNCER: Researchers continue to search for newer drugs with fewer side effects which will create longer-lasting relief from Parkinson's symptoms.

C. WARREN OLANOW, MD: The hope is that we'll eventually, or soon, preferably, develop a treatment that slows down or even stops the progression of the disease so that we can control the signs and symptoms and further levels of disability don't evolve. I think that's a realistic hope, and that we could potentially have such treatments within the next decade or two.

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