donation
To request Mental Health
Services or to access Mental
Health Crisis Services Call:
1-800-375-4357

Medical Disorders
Resources
Basic InformationLookupsLatest News
COVID Infection Unlikely From Hospital Surfaces: StudyMany People With Asthma Have Mixed Feelings About Masks: PollMore Proof That COVID Vaccines Won't Harm FertilityMore Than 1 Million U.S. Kids Diagnosed With COVID in Single WeekBiden Administration Withdraws Vaccine Mandate for Large EmployersOmicron Batters Already Strained U.S. Hospitals3 Factors Helped Teens Stay Mentally Healthy During PandemicVaccination Key to 'Super Immunity' Against COVID-19Pandemic to Endemic: Is a New Normal Near?Pfizer Begins Testing a COVID Vaccine Targeted to Omicron3 Reasons Why Trying to Get COVID Is a Bad IdeaFree N95 Masks Begin Arriving in U.S. PharmaciesOmicron Shows Signs of Ebbing as U.S. Cases Fall, Hospitalizations Level OffFDA Limits Use of Two COVID Antibody TreatmentsCOVID Can Affect Brains of Hospitalized KidsCOVID Vaccine Hesitancy Falling Faster Among Black Americans Than WhitesEngland to Lift Travel Restrictions for Vaccinated VisitorsAre Pins or a Cast Better for a Broken Wrist?FDA May Limit Use of Two COVID Antibody TreatmentsSome Patients With Macular Degeneration Could Stop Monthly Eye InjectionsYou Don't Have to Smoke to Get Lung CancerCOVID Vaccine Won't Affect Fertility, But Getting COVID MightThree New Studies Confirm Power of Booster Shots Against OmicronHit Your Head? Look for These Warning Signs of ConcussionArthritis & the COVID Vaccine: What You Need to KnowCOVID Boosters Keep Older Americans Out of Hospitals: CDCCOVID Rapid Test Makers Struggling to Meet DemandAHA News: A Healthy Thyroid Can Be Key to a Healthy Heart'Artificial Pancreas' Can Help Kids With Type 1 DiabetesGetting Back to Sports After Recovering from COVID-19Side Effects From New Cancer Meds Have Silver LiningNew Clues to Why Some Develop 'Brain Fog' After COVIDVaccination Plus Prior Infection Best Defense Against COVIDBinge-Watching Could Raise Your Blood Clot RiskIs a Night in the Hospital Necessary After Hip, Knee Replacement?Crowded Emergency Rooms Cost Lives: StudyNo Side Effects From Your COVID Vaccine? Don't Worry, It's Still WorkingNearly Half of Americans Gained Weight in Pandemic's First YearNo Evidence Breastfeeding Can Transmit CoronavirusWHO Says Worst of Pandemic Could Ease This Year if Vaccine Inequities ErasedBiden Plans to Send 400 Million N95 Masks to Americans for FreeHeart Function Rebounds for Kids With COVID-Linked MIS-CAHA News: What Heart and Stroke Patients Need to Know About COVID-19 in 2022Which Kids Are Most Vulnerable to Severe COVID-19?Vaping Might Worsen COVID-19 SymptomsToo Soon to Tell if Omicron Will End Pandemic: FauciWhite House Launches Website for Free Home COVID Tests One Day Ahead of SchedulePolitics Clouds Folks' Views on COVID Rules, Global Survey ConfirmsCOVID-19 Treatments: What You Need to KnowAt-Home COVID Tests Accurate for Ki​ds: Study
Questions and AnswersLinksBook Reviews
Related Topics

Cancer
Men's Health
Women's Health

Neurologists' Group Issues New Treatment Guidelines for Early Parkinson's

HealthDay News
by Robert Preidt
Updated: Nov 19th 2021

new article illustration

FRIDAY, Nov. 19, 2021 (HealthDay News) -- Guidelines for treating movement problems in people in the early stages of Parkinson's disease have been updated.

The new treatment recommendations from the American Academy of Neurology (AAN) focus on dopaminergic medications, which increase dopamine levels or mimic dopamine effects. Parkinson's is a movement disorder that occurs when nerve cells in the brain fail to produce enough dopamine.

The new guideline updates treatment recommendations published in 2002.

"We carefully reviewed the available research on the effectiveness and possible risks of medications to treat motor symptoms in people with early Parkinson's disease and found that levodopa is usually the best first treatment for these symptoms," said Dr. Tamara Pringsheim, lead author of the updated guideline. She's a professor in clinical neurosciences at the University of Calgary in Alberta, Canada.

The guideline says neurologists should counsel patients on the benefits and risks of initial therapy with three treatment options: levodopa, a drug that is converted into dopamine in the brain; dopamine agonists, drugs that mimic the effects of dopamine; and monoamine oxidase B (MAO-B) inhibitors, drugs that prevent an enzyme called MAO-B from breaking down dopamine.

Treatment with levodopa is better at reducing motor symptoms in early Parkinson's patients than either dopamine agonists or MAO-B inhibitors, according to the guideline published online Nov. 16 in the journal Neurology.

"Still, there are side effects with levodopa as well as other drugs, so it is important that a person newly diagnosed with Parkinson's disease discusses all options with their neurologist before deciding on the best treatment plan for them," Pringsheim added in an AAN news release.

Levodopa is more likely than dopamine agonists to cause dyskinesia — involuntary, erratic writhing movements of the face, arms, legs or trunk — during the first five years of treatment, but rates of severe or disabling dyskinesia were low during that time.

The guideline says neurologists should prescribe the lowest effective dose of levodopa to maximize benefits and minimize dyskinesia risk.

While dopamine agonists are less likely to cause dyskinesia, they are more likely to cause impulse-control disorders, such as compulsive gambling, eating, shopping or sexual activity, as well as hallucinations, according to the guidelines.

They are also associated with a greater risk of excessive daytime sleepiness, so people with jobs that require driving or operating heavy machinery may face greater problems from these side effects, the guideline warns.

It also said that patients are more likely to stop their treatment due to side effects when taking dopamine agonists and MAO-B inhibitors than when taking levodopa, and that patients taking MAO-B inhibitors are more likely to require additional therapy within two to three years.

"Choosing to start a medication is a collaborative decision between a person with Parkinson's disease, their neurologist, and their caregiver," Pringsheim said. "The right medication will depend on a person's symptoms, age and life circumstances. They are encouraged to discuss the potential benefits and adverse effects of medication options with their neurologist and care team."

More information

The Parkinson's Foundation has more on Parkinson's disease.

SOURCE: American Academy of Neurology, news release, Nov. 15, 2021