Many symptoms of Parkinson’s result from a loss of brain cells that produce the neurotransmitter dopamine.
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For this reason, several medications for Parkinson’s disease either raise the level of dopamine in the brain or mimic its effects. Meanwhile, other medications help control nonmotor symptoms of Parkinson’s or target other neurotransmitters to mitigate symptoms.
Drugs That Increase Dopamine
Levodopa, the precursor to dopamine, can be an effective treatment for more advanced cases of Parkinson’s disease.
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It’s often combined with carbidopa to reduce side effects and to increase the amount of levodopa available to brain cells. While levodopa can temporarily help replace some of the lost dopamine in the brain, carbidopa helps improve the uptake of levodopa by preventing it from being activated into dopamine before it reaches the brain.
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Carbidopa-levodopa is available as an oral medication under the brand names Crexont, Rytary, and Sinemet.
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It’s also available as an infusion under the brand names Duopa and Vyalev.
Drugs That Mimic Dopamine
A number of medications mimic dopamine in the brain to address Parkinson’s symptoms, including:
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- apomorphine (Apokyn, Kynmobi)
- pramipexole (Mirapex)
- ropinirole (Requip)
- rotigotine (Neupro)
MAO-B Inhibitors
These medications inhibit the enzyme monoamine oxidase B (MAO-B), which breaks down dopamine in the brain, helping dopamine remain intact for the brain to use. MAO-B inhibitors include:
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- rasagiline (Azilect)
- safinamide (Xadago)
- selegiline (Zelapar)
COMT Inhibitors
These medications help block another enzyme, catechol-O-methyltransferase (COMT), from breaking down dopamine in the brain. This group of medications includes entacapone (Comtan) and opicapone (Ongentys).
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Amantadine (Symmetrel)
Amantadine (Gocovri, Symmetrel) is an antiviral medication and an antidyskinetic medication that may be prescribed to those with Parkinson’s to help address sudden uncontrolled movements (dyskinesia). Amantadine can be taken alone or alongside other medications for Parkinson’s, such as levodopa.
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Anticholinergics
Anticholinergics can be helpful for reducing tremor and muscle contractions by reducing the action of a neurotransmitter called acetylcholine that’s involved in activating muscles.
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Anticholinergics prescribed for Parkinson’s include benztropine (Cogentin) and trihexyphenidyl (Artane).
Medications for Nonmovement Symptoms
While many medications focus on motor symptoms common with Parkinson’s disease, other drugs may help various nonmotor or nonmovement symptoms of the disorder.
Atypical antipsychotic medications may be used (some off-label) to treat the hallucinations and delusions that some people with Parkinson’s experience.
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These drugs include:
- pimavanserin (Nuplazid)
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- clozapine (Clozaril)
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- quetiapine (Seroquel)
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Stimulants, including modafinil (Provigil) and armodafinil (Nuvigil), may also be used to help treat excessive daytime sleepiness in people with Parkinson’s disease.
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Cholinesterase inhibitors are used to treat dementia or cognitive problems. While these medications were developed to treat Alzheimer’s disease, they can also be used by people with Parkinson’s.
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