The purpose of treating Parkinson’s (PD) is to reduce the effect of symptoms on your daily life. Without treatment, the symptoms will progressively make daily activities challenging, cause discomfort, increase the risk of falls and injuries, and lead to difficulties with speech and swallowing.

It is important to find the right balance between the medication’s benefits and side effects. Everyone with PD is unique and will experience different symptoms, which means the treatment you receive will be geared to your specific needs. Drugs for PD work on the brain’s complex chemistry and may need to be taken several times a day. Use them as prescribed, and do not alter your doses without consulting your doctor. Current treatment neither cures Parkinson’s nor stops it from advancing.

 

Prescription

If you have been diagnosed with Parkinson’s, you may be wondering when you should start treatment, and with which medication. There is no single strategy that applies to everyone. The timing will differ from person to person. It depends on a variety of factors, such as:

  • your age
  • the nature of your symptom(s)
  • your lifestyle (e.g. if you are working or retired, and the kind of leisure activities you enjoy)
  • your overall physical health, including any pre-existing medical conditions you may have (e.g. high blood pressure, diabetes)
  • whether you experience balance problems when walking
  • changes in intellectual abilities
  • your own attitude toward taking medication

What about medications for other health conditions?

The effectiveness of some Parkinson’s drugs can be reduced when combined with drugs for other health conditions. It is important to seek advice from your doctor or pharmacist regarding any new drug prescription.

 

Medication on Time, Every Time

The timing of medications is an important way to control your symptoms. Follow the guidelines provided by your healthcare professional.

  • Use a timer to remind you to take your medication on time to avoid double-dosing.
  • Take each dose with a full glass of water to aid absorption.
  • Do not break, crush, or chew controlled-release tablets, unless instructed by your doctor.
  • For nausea, take the drug after meals, or with a snack, such as a cracker or fruit. If you are taking levodopa, be careful not to eat protein-rich foods, such as meat, cheese, and eggs, with your medication. Protein can impact how levodopa is absorbed.
  • Keep an accurate list of all medications, including over-the-counter products, herbal remedies, and vitamins or supplements.

 

Side Effects

The most common reactions, which occur within the first several days of a new treatment, include nausea, vomiting, dizziness, low blood pressure, daytime sleepiness, and visual hallucinations.

In the last few years, levodopa, and dopamine agonists in particular, (ropinirole [ReQuip], pramipexole [Mirapex]) have been associated with the emergence of behavioral changes such as impulse control disorders. These are characterized by failure to resist an impulse to perform certain actions.

Impulse control disorders include a range of behaviors such as compulsive gambling (up to 5% of treated patients) or shopping, hypersexuality, binge eating, and addiction to the Internet or to other recreational activities. These activities are often pleasant in the moment, but, over time, may become harmful. If you are experiencing these behaviours, talk to your healthcare team. Often, the medication can be adjusted to reduce or control the behaviour.

Carepartners can play an important role in helping to identify when these behaviours occur. If you are a carepartner, tell the person if you have noticed a change in their behaviour or personality, and encourage them to speak with the doctor immediately so medication can be adjusted.

 

Talking to Your Doctor

You might find it helpful to write down any questions you have before your next appointment. This can help make your visit more efficient. Here are a few questions you may wish to ask:

  • What are the benefits of each kind of medication?
  • What are the side effects, and how can I manage them?
  • When do I take the medication relative to mealtime to get the best result?
  • How soon can I expect the treatment to start working?
  • How will treatment affect my daily activities?
  • How often do I need to follow up with my doctor about my medications?
  • Do drugs lose their effectiveness over time if I start treatment early on?
  • Should I be concerned about impulse control problems?
  • Are my medications covered by the provincial drug plan?
  • Would a clinical trial be appropriate for me? Can you help me find one?

Last updated: May 15, 2024