2023-07-11 21:43:27
Drug Science: A Comprehensive Overview of Parkinson’s Medications
In this new series of articles, we aim to provide a comprehensive understanding of the various drugs used to treat Parkinson’s disease. In this first episode, we will begin with a simple overview of the drugs and how they work. Future articles will delve into more detail about the individual drug groups and types.
One common misconception among Parkinson’s patients is that their previous medications are no longer effective because their bodies have become too accustomed to them. However, this assessment is often incorrect. The medication’s efficacy does not wear off, but rather Parkinson’s symptoms may worsen over time, necessitating a higher dose, a more precise regimen, or additional medication.
Many of these drugs are also marketed under their active ingredient names, known as generic names. Other drugs have artificial names created for marketing purposes. While the list below includes most of these artificial names, it may not encompass all the sales names commonly used in Austria and Switzerland.
Here is an overview of some Parkinson’s medications:
Levo-Dopa:
Levo-Dopa exists in a pure form, but it is susceptible to being destroyed by an endogenous enzyme called dopa decarboxylase (DDC). To counter this, all modern L-Dopa preparations contain a DDC inhibitor, either benserazide or carbidopa, in a 4:1 ratio. These inhibitors help enhance the effectiveness of Levo-Dopa. Some common Levo-Dopa preparations include Madopar®, Madopar Depot®, MadoparLT®, Nacom®, Nacomretard®, Duodopa®, MyFID®, Rytary™, and Numient®.
Levo-Dopa in triple combination:
Stalevo® combines Levo-Dopa with carbidopa and entacapon.
Dopamine agonists:
Dopamine agonists mimic the effects of dopamine in the body but differ chemically. These drugs can be considered dopamine substitutes. Examples include Apomorphine Injection Solution®, Dacepton®, Pramipexol, Sifrol retard®, Oprymea®, Mirapexin®, Glepark®, Ropinirol, ReQuip®, Adratel®, Rotigotine Neupro®, Reader®, Piribedil, Clarium®, Pronoran®, and Trivastal.
MAO Inhibitor:
Monoamine oxidase (MAO) is an enzyme responsible for breaking down dopamine in the synapse. MAO inhibitors slow down this enzyme, allowing dopamine to have a longer-lasting effect. Selegel, Azilect®, and Rasagea® are examples of MAO inhibitors used in Parkinson’s treatment.
Anticholinergics:
Although drugs in this category have largely lost their significance, anticholinergics can still be used in some cases. Biperiden, Akineton®, methixen, and Bornaprin are examples of anticholinergics.
NMDA Antagonists – Glutamate Antagonists:
Amantadine is a drug in this category that acts as an NMDA antagonist, which has been found to be beneficial in Parkinson’s treatment. Budipin, another drug in this category, is less commonly used. PK-Merz® and Tregor® are brand names for amantadine, while Parkinson’s® is a brand name for budipin.
Safinamide:
Similar to MAOIs, safinamide is an active ingredient that offers additional benefits. Xadago® is a brand name for safinamide.
COMT-Inhibitors:
Catechol-O-methyl-transferase (COMT) inhibitors prevent Levo-Dopa from being prematurely broken down in the body, extending its effectiveness. Tolcapon, Tasmar®, Entacapon, Comtess®, Opicapon, and Ongentys® are examples of COMT inhibitors. Additionally, there is a fixed combination of Levo-Dopa, carbidopa, and entacapone available.
It’s important to note that this is not an exhaustive list, and new drugs may be introduced in the future. Stay tuned for the next articles in this series, where we will explore each drug group and type in more detail.]
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