13 Medications to Help Control Parkinson’s Disease Symptoms

A movement disorders specialist explains the different types of Parkinson’s medications, their side effects and how they can help manage symptoms.

7:00 AM

Author | Kara J. Wyant, M.D.

Graphic depicting different types of Parkinson disease medication

If you have Parkinson's disease, there aren't any treatments that can slow, reverse or stop the condition's progression. But although there is no cure, more than a dozen medications can help patients manage symptoms.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

Our goals when prescribing medications for Parkinson's disease are twofold: to improve day-to-day functioning and quality of life and to keep people functioning as long as possible. Hopefully, your physician has the same goals in mind for you.

In the University of Michigan clinic, we work with people individually to find the best medication for them. Here's an overview to help you manage your care.

Picking a Parkinson's medication

When assessing which medications will work best, we ask patients the following questions:

  • Are you able to do what you want to do?

  • Are the medications you are taking now wearing off before the next dose?

  • Do your medications have side effects? If so, what are they?

  • Are you having dyskinesias (extra involuntary movements)? If so, how bothersome are they to you?

Based on the answers to those questions and the medical exam, we choose a medication from the following list:

Carbidopa-levodopa (Sinemet): The most effective and well-tolerated drug the medical profession has to offer at this time is carbidopa-levodopa. It often helps with bradykinesia (rigidity and rest tremor). It generally does not help with imbalance or falls, freezing and non-motor symptoms.

Side effects include:

  • Dyskinesia (abnormal, involuntary movements)

  • Nausea

  • Hallucinations

  • Confusion

  • Lightheadedness

Patients should also be aware of these important dosing instructions:

  • Take 30 minutes prior to meals (note that a high-protein diet may decrease absorption of the drug).

  • Generally, do not take it right before bed unless you need it overnight to reduce cramping or restless leg syndrome.

  • Consistent timing is important. If you miss a dose, your symptoms may return.

Sinemet controlled-release tab: This drug can be given at night to help with early morning symptoms, or it may be used instead of the immediate-release version to decrease nausea.

  • It has not been shown to help treat motor fluctuations (variable "on-and-off," early morning "off," etc.) and dyskinesia.

Rytary: This drug is a new, long-acting carbidopa-levodopa.

  • It provides an extra one to two hours of "on" time per day compared with regular Sinemet.

  • Rytary is not available in a generic version, so it may be expensive. Some insurance companies do cover it.

Dopamine agonists (pramipexole, ropinirole, rotigotine patch): There is good evidence to support that these medications work by themselves or in combination with Sinemet. If they are used in combination, it helps prolong the effect of the Sinemet.

  • Significant side effects can limit their use, including:

  • Nausea

  • Dizziness

  • Leg swelling

  • Sleepiness and sleep attacks

  • Worsening cognition

  • Hallucinations

  • Impulse control disorders

Apomorphine: Effective in patients with severe motor fluctuations, it can be useful to get patients going in the early morning or during "off" times.

  • This medication is injected, which many people don't like. In addition, it can cause severe nausea, so it requires scheduled anti-nausea therapy. The first dose will need to be monitored in the office to ensure safety, tolerability and adequate dosing.

SEE ALSO: Deep Brain Stimulation for Parkinson's Disease: Is It Right for You?

MAO-B inhibitors (selegiline, rasagiline): These may have a mild symptomatic benefit early in the course of Parkinson's disease.

  • Similar to dopamine agonists, this medication may help to smooth the motor fluctuations in advanced disease.

  • They may also be used with Sinemet to prolong the action of the Sinemet.

  • Many people with Parkinson's have mood disorders, and there could be a drug interaction if these medications are taken with certain antidepressants. Patients should be watched closely.

COMT inhibitors (entacapone, tolcapone): These drugs decrease "wearing off" in advanced disease.

  • They may make the side effects of carbidopa-levadopa worse.

Amantadine: This may have a modest effect on motor symptoms in early Parkinson's, but it is particularly helpful with treating dyskinesia.

  • Cognitive (thinking and memory) side effects may limit its use.

Trihexyphenidyl (Artane): This can be helpful in treating rest tremor if refractory to Sinemet and dopamine agonists, but side effects may limit its use.

Nonpharmacologic treatments

If you have a neurologist, he or she will harp on exercise, exercise, exercise. People with Parkinson's disease who participate in exercise and exercise therapies will improve their ability to function. We encourage 30 minutes of activity every day.

Speech therapy is also beneficial because patients often develop a soft voice, and they can learn how to project their voice. Such therapy may also help if they develop swallowing problems.

For more information, watch Dr. Wyant's talk from the University of Michigan's 2016 Parkinson's & You Symposium.

More Articles About: Health Management Neurodegenerative Disorder Parkinson's Disease Neurological (Brain) Conditions
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]


Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Featured News & Stories
Health Lab
Motor and Non-Motor Symptoms for Diagnosing Parkinson’s Disease
A movement disorder specialist explains the hallmark signs of Parkinson’s disease as well as the non-movement symptoms associated with the condition.
Patient lies in hospital bed after surgery with bandage on head, displays toys later after recovery
Health Lab
Lifechanging results for young woman after orange-sized brain tumor removed
Young woman thrives after surgery to remove a pilocytic astrocytoma tumor in her brain.
Three year old patient poses by Wonder Woman statue, wears costume
Health Lab
Three-year-old Wonder Woman making strides after customized spinal procedure
Three year old Wonder Woman fan thrives after customized minimally invasive selective dorsal rhizotomy to help symptoms of cerebral palsy and spastic diplegia
Illustration of neuron cell
Health Lab
Two genes linked to autism implicated in brain cell connectivity
A new study links two autism-associated genes together for the first time, potentially revealing a mechanism behind brain changes seen in people with autism.
brain image
Health Lab
Death rate higher than expected for patients with functional, nonepileptic seizures
The death rate for patients with functional, nonepileptic seizures is higher than expected, with a rate comparable to epilepsy and severe mental illness, a Michigan Medicine-led study finds.
Paxlovid pill green Covid medicine
Health Lab
A how-to guide to COVID treatments
A Michigan Medicine FAQ about Paxlovid, with new information since its FDA approval in May 2023.