The Fox Focus Spring/Summer 2017 - Page 12

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. 12 The Fox Focus