We are on the cusp of making some really great discoveries especially with the potential to slow down the disease, reverse the symptoms and certainly the holy grail of coming up with a cure.
– Trevor Hawkins, MD
The crux of the problem in Parkinson’s is the cell death of neurons in the brain that produce dopamine.
In this episode with Dr. Trevor Hawkins, you will learn:
- The three main types of medications used to treat the motor symptoms of Parkinson’s
- How to make up for the cells that have already died off
- Common misconceptions about Levodopa
- Side effects of the most common medication that treat Parkinson’s
- Common non-motor symptoms and how medications can potentially reduce those too
- By the time someone begins seeing signs of Parkinson’s, they only have 10-20% of their dopamine-producing cells left
- The goal with medications like carbidopa/levodopa is to get the remaining cells to pump out more dopamine and potentially make up for the cells that have died off
- Cell to cell communication in the brain is much like a paperboy/papergirl delivering papers to your doorstep
- MAO Inhibitors keep the nosy neighbor at home by letting the dopamine hang out longer and giving it a better chance of delivering the message across the synapse – they stop the enzyme that clears out the dopamine before the cell has a chance to get it
- Dopamine agonists bypass all of the machinery and go straight to the doors (think about magazines that are delivered straight to your mailbox)
- All three of the medications treat motor symptoms, they don’t stop, slow down or cure Parkinson’s
- Still, in many cases, non-motor symptoms can get better as well. If you’re not as burdened by motor symptoms, you’ll feel better, you won’t be as depressed, you’ll be in a better mood, you’ll sleep better and you’ll likely be more active
- Common misconception: levodopa is actually not toxic to neurons and it won’t increase the speed of Parkinson’s progression – it can still work after many decades of being on it
- It used to be believed that dyskinesias were related to when you started levodopa, but it has nothing to do with that. It just has to do with the progression of Parkinson’s for you
Concepts Mentioned in this Podcast & Further Reading
- The Neuroscience of Parkinson’s
- MAO Inhibitors
- Dopamine Agonists
- What, When, Why, How & More of DBS for the Newly Diagnosed
- How to Bring Light to the Darker Side of Parkinson’s: A Primer on Hallucinations and Delusions and How to Manage Them
- What is REM Sleep Behavior Disorder?
- Living Well with REM Sleep Behavior Disorder
- Impulse Control Disorders (ICDs) in Parkinson’s: What They Are and How to Manage Them
Dr. Trevor Hawkins is an assistant professor of neurology at the University of Colorado School of Medicine Anschutz Medical Campus.
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