Prescribing medications for Parkinson's: part two

Abstract

Around 10 million people worldwide have Parkinson's and in the UK the estimated figure is 153 000. The condition is characterised by motor symptoms including tremors, stiffness, slowness, balance problems and/or gait disorders, but people can develop a wide range of associated psychological and physical problems. Treatment for Parkinson's includes a combination of multidisciplinary input from specialists such as physiotherapy, speech and language therapy and occupational therapy, alongside the use of recognised medication regimens. Most first-line medication requires titration and is started at a low dose and increased gradually, to reduce the risk of side effects and to monitor response to treatment. Medications for Parkinson's are complex to manage, and many have side effects that could affect patient concordance. Any prescribing decisions should be discussed with the person with Parkinson's and their family members. There are a variety of medications available to manage motor and non-motor symptoms in Parkinson's, but this article will focus on levodopa, dopamine agonists, MAO-B inhibitors and catechol-O-methyltransferase inhibitors.