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Navigating Medications for Parkinson's

Medication is an important part of your overall care. Choosing when to start medication for Parkinson’s varies from person to person. Initially, Parkinson’s symptoms may be mild and not interfere with daily routines. A good rule of thumb is to start medication when your Parkinson’s symptoms become restricting or disruptive to your daily activities and quality of life in some way.

Currently, Parkinson’s medication treatments are divided into Motor and Non-Motor symptom categories. Which medication is best for you depends on many factors, including your symptoms, age, time living with Parkinson’s, and risk for side effects. Any of the available medications can be used early in the progression of Parkinson’s depending on these factors.

Parkinson’s symptoms may be mild for several years, requiring small doses of medication. During the first few years of treatment, controlling motor symptoms is also generally smooth, and missing a dose or two of medication may not even be noticeable. However, as the number of years with Parkinson’s increases, fluctuations in the benefits of medication may emerge, and symptoms may begin to breakthrough before the next dose is due. During these “Off” times, problems with gait, freezing, anxiety, speech, imbalance, tremor, stiffness, slowness and posture can be very pronounced. You may start to feel like you are on a roller coaster when you feel good (On) at times and worse (Off) at other times.

That is why it is so important to see a Movement Disorder Specialist for the treatment of Parkinson's. Movement Disorder Specialists have comprehensive expertise when it comes to navigating the various types of medications. They have experienced more trial and error from working with other Parkinson's patients to help you navigate your choices. Communicating clearly and well with your specialist is important to be able to get to the best balance of medications to manage your Parkinson's symptoms.

If these symptoms occur, you and your physician can adjust your medications to reduce your off periods. These adjustments may include taking medication doses closer together, using longer-acting medications, such as dopamine agonists, or using carbidopa/levodopa boosters, such as MAO-B or COMT inhibitors.

As is the case with any medication, different people tolerate the same Parkinson’s medications very differently. Some people experience medication side effects severe enough to warrant a change of course, while others experience few or no side effects. If you experience side effects with your medication, especially if the side effects interfere with your ability to go about your normal activities, discuss this with your physicians as soon as possible. Your dosage might need to be adjusted, or your physician might choose a different medication or combination of drugs.

Treatment for Parkinson’s is focused on achieving the most ON time and limiting OFF time as much as possible to give you the highest quality of life. However, as medications are increased, dyskinesias – involuntary, irregular jerking or wiggling movements – can become a problem. To treat dyskinesias, medication dosages may be reduced or changed completely.

To learn more about the various types of medications available to Parkinson’s, visit

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