Dear Dr. Komaroff: I’ve been taking levodopa for years to treat my Parkinson’s disease. Lately, though, it hasn’t been as effective. Are there any other treatment options?
Dear Reader: It is common for the effectiveness of levodopa to change over time. Fortunately, there are other treatments available. Some are very high tech, reflecting the latest scientific knowledge. Others are very low tech, reflecting the wisdom of the past.
Parkinson’s disease occurs when a part of the brain does not make enough of the chemical signal dopamine. Drugs such as levodopa can fill in for natural dopamine and ease symptoms.
If the drug has become less effective, your doctor can try adjusting the dose or schedule of your medication. There also are other types of medicines that can be used alone or in combination with levodopa, and your doctor might want you to try one of these.
A nondrug type of treatment that has been used for more than a decade to help control Parkinson’s symptoms is known as deep-brain stimulation. It involves placing a tiny wire called a lead in the part of the brain that controls movement. A matchbook-sized stimulator is implanted under the skin below the collarbone. The lead and stimulator are connected to each other by a second wire. This wire runs under the skin of the shoulder, neck and head. The device emits small pulses of electricity that are received by the wire in the brain and help to coordinate movement. This stimulation – either alone or in combination with levodopa – might help control your symptoms.
Another, much lower-tech option is tai chi. Tai chi is an ancient Chinese practice that I’ve talked about several times before in this column. It enhances balance and muscle strength, helps prevent falls and girds against physical decline.
People with Parkinson’s can reap these benefits of tai chi. Its benefits were demonstrated in a study published in the New England Journal of Medicine.
Dr. Anthony Komaroff is a physician and a professor at Harvard Medical School. To submit a question, go to his website, askdoctork.com.