New Treatment Options for Parkinson’s Disease
The FDA has approved a new medication therapy for the treatment of Parkinson’s disease. The new drug is rotigotine (Neupro), which is in the family of dopamine agonists. Dopamine agonists mimic the effects of levodopa (Sinemet) without having to go through chemical transformation. Other dopamine agonists include Mirapex and Requip. Neupro is different in that it comes in the form of a patch. This has the advantage that the medication is delivered continuously through the skin, while you are wearing the patch. Theoretically, this would provide a more even blood concentration of medication throughout the day. Patients using Neupro should not be taking one of the other dopamine agonists. This patch can be used alone or in combination with other Parkinson medications, to help improve the daily function of patients affected with Parkinson’s disease. Side effects include low blood pressure, foot swelling, hallucinations and stomach upset – just like the other dopamine agonists. Neupro can also cause contact dermatitis (rash) from the patch adhesive. This is similar to what some patients experience with bandages and medical tape. The dopamine agonists help Parkinson patients in many ways including use of less Sinemet and decreasing dykinesias. Dykinesia is an involuntary movement that can affect the head, shoulders, arms and legs. The development of dyskinesia is related to the amount and duration of use of Sinemet.
Another new medication that was approved by the FDA is a drug called Azilect (Rasagiline.) This is in the class of medications known as the MAO-B inhibitors. MAO is a an enzyme in the body that breaks down dopamine. By inhibiting MAO-B, Azilect allows more dopamine to enter the brain. It also theoretically slows the breakdown of dopamine. Dopamine is the main brain chemical transmitter that is lacking in Parkinson patients. This drug can be used by itself or in combination with other Parkinson medications, particularly levodopa (Sinemet.) Unfortunately, like other Parkinson drugs, Azilect does not work for everyone.