Medication for Parkinson’s Disease

Levodopa is the most effective medication for managing the symptoms of Parkinson’s disease. It is absorbed in the bloodstream and travels to the brain, where it’s converted into the brain chemical dopamine. People with Parkinson’s disease have lower levels of dopamine than without the condition. 

Doctors prescribe levodopa in combination with another medication called carbidopa, which reduces the risk of side effects such as nausea and vomiting. This combination medication is available as a generic formulation and also under the brand names Sinemet^®, Parcopa^®, and Rytary™. 

Over time, people with Parkinson’s disease notice that the medication wears off between doses and they need to take it more frequently. They may also develop involuntary movements called dyskinesias. To control these effects, your doctor may adjust the dose or timing of the medication.

Dopamine agonists are another commonly used class of medications for Parkinson’s disease. These medications mimic the action of dopamine in the brain. They include medications such as pramipexole (Mirapex^®), ropinirole (Requip^®), and rotigotine (Neupro^®). 

Although dopamine agonists may be less effective at controlling symptoms than levodopa, they are longer acting. These medications can be taken by themselves or in combination with levodopa.

Some of the side effects of dopamine agonists are similar to those of levodopa, but dopamine agonists are more likely to cause hallucinations or drowsiness than levodopa. In addition, dopamine agonists may cause leg swelling, sudden onset sleep—sometimes called “sleep attacks”—and compulsive behaviors, such as eating, gambling, shopping, or hypersexuality. Your doctor carefully monitors your condition while on these medications in order to manage side effects.

NYU Langone doctors may prescribe other classes of medications alone or in combination with levodopa or dopamine agonists. These may include: 

• monoamine oxidase B inhibitors, such as selegiline (Eldepryl®) or rasagiline (Azilect®)
• catechol-O-methyltransferase inhibitors, such as entacapone (Comtan®) or tolcapone (Tasmar®)
• anticholinergic medications, such as trihexyphenidyl (Artane®) and benztropine (Cogentin®)

Medication for Parkinson’s disease is often taken long term. NYU Langone doctors provide regular follow-up care to ensure adequate treatment of motor and behavioral symptoms. After symptoms are stable, doctors recommend follow-up care every three to six months. 

During these visits, doctors may monitor your response to medication and adjust dosages as needed to control symptoms and minimize side effects. Doctors also address any related nonmotor conditions, such as sleep disorders, mood disorders, psychosis, and dementia.