Medication plays a crucial role managing Parkinson’s symptoms.

You don’t have to struggle or just get by when medications can help you participate more fully in everyday activities.

Benefits of starting Parkinson’s medications

Why replace dopamine?

Parkinson’s is caused by a loss of dopamine—a chemical in the brain that helps control movement and other functions. Dopaminergic neurons in a part of the brain called the substantia nigra are responsible for producing and releasing dopamine. Although these neurons make up just 3–5% of the total cells in the substantia nigra, they are vital for processing signals that guide movement and coordination (Sulzer, 2007).

When these neurons die or stop functioning effectively, the brain’s dopamine supply diminishes. Medications like levodopa work by either replacing the lost dopamine, mimicking its action (agonists), or slowing down the breakdown of existing dopamine (inhibitors), allowing your brain to use it for longer (Obeso et al., 2017). This is why these medicines remain effective throughout all stages of Parkinson’s.

Acting early matters!

It’s important to start medication while you still have the most neurons working, as this allows you to optimise symptom relief and preserve your independence for as long as possible. Research has shown that delaying treatment can lead to a reduced quality of life and unnecessary suffering due to poorly managed symptoms (Hauser, 2009). Early treatment can improve mobility, reduce rigidity, and enhance overall wellbeing, giving you more opportunity to slow progression through exercise and maintain social connections.

Levodopaphobia

Levodopaphobia refers to the fear or reluctance to start or continue levodopa treatment, a cornerstone medication for managing Parkinson’s disease. It can significantly impact their quality of life.

Causes of Levodopaphobia

  • Many people with Parkinson’s worry about potential side effects of levodopa, such as dyskinesias (involuntary movements), which are more common with long-term use (Thanvi et al., 2007).
  • Some believe that levodopa becomes less effective over time, leading to a reluctance to start treatment early.
  • People with YOPD may wish to postpone levodopa use, fearing they will “run out of options” later in life.

Impact on people living with young onset Parkinson’s

For those with YOPD, levodopaphobia can be particularly challenging. Younger people often face unique life-stage pressures, such as managing careers, raising families, and maintaining social roles. Avoiding levodopa can lead to poorly managed symptoms, which may interfere with these responsibilities and reduce participation in things that make their life enjoyable and increase wellbeing.

Addressing Levodopaphobia

  • Providing accurate information about levodopa’s benefits and addressing misconceptions can help alleviate fears.
  • Tailoring medication regimens to individual needs and concerns can improve adherence and outcomes.
  • Connecting with your care team, support groups, and participating in conferences put on by trusted organisations like Parkinson’s Australia can provide reassurance and guidance.

Key Statistics

  1. Studies show that dopaminergic medications, such as levodopa, improve motor symptoms in up to 70–80% of patients, significantly enhancing their ability to perform daily activities.
  2. Research using the Parkinson’s Disease Questionnaire (PDQ-39) found that patients on effective medication regimens reported a 30–40% improvement in their overall Quality of Life (QoL) scores compared to those with insufficient symptom control.
  3. Advanced medication delivery methods, like continuous infusion pumps, reduce “off” times (periods when symptoms return) by up to 50%, allowing for more consistent symptom management.
  4. Medications targeting non-motor symptoms, such as depression and sleep disturbances, improve QoL by addressing these often-overlooked aspects of Parkinson’s. For example, antidepressants can reduce depressive symptoms by 40–60% in patients with Parkinson’s.

Statistics from: Tsugawa et al. (2015)

On time, every time

Taking your Parkinson’s medications on time, every time, is crucial for effectively managing your symptoms and maintaining your quality of life. Here’s why:

  1. Maintaining dopamine levels: Parkinson’s medications, such as levodopa, work by either replacing or mimicking dopamine in the brain. Dopamine levels naturally fluctuate throughout the day, so consistent timing ensures a steady supply, reducing “off” periods (when symptoms return or worsen) and preventing unnecessary discomfort.
  2. Avoiding motor fluctuations: Irregular timing of medications can lead to motor fluctuations, including wearing-off effects (where the medicine stops working before your next dose) or dyskinesias (involuntary movements often experience with too much dopamine). Sticking to a strict schedule minimises these complications and keeps your symptoms better controlled.
  3. Supporting the brain’s function: Early and regular medication use supports the remaining dopaminergic neurons in your brain. Consistent timing helps optimise how your brain processes dopamine, giving you the best chance at maintaining motor control and independence.
  4. Improving non-motor symptoms: Parkinson’s medications also help with non-motor symptoms like mood, sleep, and cognition. Skipping or delaying doses can worsen these, affecting your overall wellbeing.
  5. Preventing disruptions to daily life: When medications are taken inconsistently, symptoms like stiffness, tremors, and slow movement may re-emerge unpredictably, making daily activities more challenging.

By taking your medication as prescribed and on time, you’re giving your brain the best support to manage symptoms effectively. Consider setting alarms, using pill organisers, or working with your care team to ensure you stick to your schedule. Your medication is your friend—taking it on time keeps you in control, so you can focus on living your life to the fullest.

Infosheet under review

References

  • Hauser, R. A. (2009). Early pharmacologic treatment in Parkinson’s disease. American Journal of Managed Care, 15 (7 Suppl), S187-S193.
  • Obeso, J. A., et al. (2017). Past, present, and future of Parkinson’s disease: A special essay on the 200th anniversary of the shaking palsy. Movement Disorders, 32(9), 1264-1310.
  • Sulzer, D. (2007). Multiple hit hypotheses for dopamine neuron loss in Parkinson’s disease. Trends in Neurosciences, 30(5), 244-250.
  • Thanvi, B., Lo, N., & Robinson, T. (2007). Levodopa-induced dyskinesia in Parkinson’s disease: Clinical features, pathogenesis, prevention, and treatment. Postgraduate Medical Journal, 83(980), 384–388.
  • Tsugawa, J., Onozawa, R., Fukae, J. et al. Impact of insufficient drug efficacy of antiparkinson agents on patient’s quality of life: a cross-sectional study. BMC Neurol 15, 105 (2015). https://doi.org/10.1186/s12883-015-0360-y
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