Living with Parkinson’s
ASK THE MD:
TREATMENT OPTIONS
FOR ADVANCING
PARKINSON’S DISEASE
As Parkinson’s disease (PD) progresses over time, symptoms evolve and
drug-associated complications may arise. An expanding repertoire of
treatments means patients have more options at all stages of disease.
In the right candidates, deep brain stimulation (DBS) and Duopa, a new
levodopa formulation, hold potential to lessen motor symptoms and im-
prove quality of life. Both are symptomatic therapies, meaning neither has
been proven to slow or stop disease progression. Depending on various
factors, it may be worth discussing with your doctor whether one of these
approaches is right for you.
DBS was approved for Parkinson’s in 2002 and
has since become the most commonly
performed surgical procedure for the disease.
In 2015, Duopa, a gel formulation of carbidopa/
levodopa infused directly into the small
intestine, was approved for use in the United
States. (Duopa was approved in Europe
under the name Duodopa in 2004.) significant medication complications. (Drug-
resistant tremor is an exception as this often does
respond to DBS.) Medication complications
can include dyskinesia (involuntary movements)
or motor fluctuations (variations in the level of
symptoms and control with medication). DBS
may be considered in people who have had
Parkinson’s for at least four years.
ABOUT DBS The majority of people can (often substantially)
limit medication use after DBS, but rarely is
DBS a complete substitution for drug therapy.
A decrease in medication brings a reduction in
associated side effects or complications, such
as dyskinesia. As settings are tweaked over
time, medications are gradually adjusted
to find the optimal combination for each
Because of general health, cognitive or other
concerns, not everyone can (or wants to)
undergo DBS surgery and the regular follow-up
necessary for programming and adjustments.
DBS doesn’t treat all symptoms of Parkinson’s.
In general, the ideal candidate is one whose
symptoms improve with medication but who has
Depending on various factors, it may be worth
discussing with your doctor whether one of these
approaches is right for you.
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The Fox Focus