Although there are general guidelines that doctors use to choose a treatment regimen, each person with Parkinson’s disease (PD) must be individually evaluated to determine which drug or combination of medications is best for them. For some, a “first choice” drug might be a form of levodopa, and for others, an initial prescription may be given for one of the dopamine agonists, an MAO inhibitor, or an anticholinergic.
The choice of medication depends on many variables including your symptoms, other existing health issues (and the medications being used to treat them) and age. Dosages vary greatly depending on a person’s needs and metabolism.
Since most Parkinson’s symptoms are caused by a lack of dopamine in the brain, many Parkinson’s drugs are aimed at either temporarily replenishing dopamine or mimicking the action of dopamine. These types of drugs are called dopaminergic medications. They generally help reduce muscle rigidity, improve speed and coordination of movement, and lessen tremor.
Always remember that medication is only part of the overall treatment plan for combatting PD. Talk to your doctor about available medications, but don’t forget exercise and complementary therapies.
Parkinson’s medications may have interactions with certain foods, other medications, vitamins, herbal supplements, over-the-counter cold pills and other remedies. Anyone taking a PD medication should talk to their doctor and pharmacist about potential drug interactions.
Generic vs. Branded Drugs
Currently, there are multiple pharmaceutical companies that manufacture a generic formulation of carbidopa-levodopa, dopamine agonists, monoamine oxidase inhibitors, and anticholinergics. The U.S. Food and Drug Administration (FDA) requires that generic drugs show a similar risk and benefit to the branded drug prior to market approval, but in rare cases this standard is not high enough.
A review supported by the Parkinson’s Foundation reports evidence that if you are in more advanced stages of the disease, switching from branded drugs to generic, or from one generic to another, may have somewhat variable effects. The authors, including Parkinson’s Foundation National Medical Advisor Michael S. Okun, MD, believe that the standards for approving generic drugs for PD may not be strict enough to demonstrate that the generic alternatives are equally effective.
Work with your doctor to develop a tailored treatment plan. Using generic drugs will likely provide a cost savings. Infrequently, a person living with PD may require brand medication.
If you make the switch, follow these tips:
- Report to your physician on the effectiveness of the drugs.
- Carefully keep a diary of any side effects.
- Record dose adjustments made by your physicians (higher or lower).
- Try to stay with a single drug manufacturer for your generic medications. You may need to ask your pharmacist to special order for you.
When attempts to tailor drug therapy with a generic drug have been unsuccessful, have your doctor appeal to the insurance company for a branded drug. It is important to include details of the various adverse side effects with the generic medication in your appeal letter.
Resources for Prescription Assistance
Offers information about assistance programs available to low-income patients and their advocates at no cost. Databases such as Patient Assistance Programs and Disease-Based Assistance, government programs, and other types of assistance programs are the crux of the free information we offer online.
Offers a comprehensive database of pharmaceutical companies’ patient assistance programs that provide free medications to people who cannot afford to buy them. Also provides practical tools, news and articles to help health care professionals and patients find the information they need.
Partnership for Prescription Assistance Program
Increases awareness of patient assistance programs and boosts enrollment of those who are eligible. Offers a single point of access to more than 475 public and private patient assistance programs, including more than 180 programs offered by pharmaceutical companies. Can be reached at 1-888-4PPA-NOW (1-888-477-2669).
Patient Access Network (PAN) Foundation
Independent, national 501 (c)(3) organization dedicated to helping federally and commercially insured people living with life-threatening, chronic, and rare diseases with the out-of-pocket costs for their prescribed medications. PAN provides the underinsured population access to the healthcare treatments they need to best manage their conditions and focus on improving their quality of life.
Page reviewed by Dr. Chauncey Spears, Clinical Assistant Professor at the University of Michigan and Dr. Amelia Heston, Movement Disorder Fellow at the University of Michigan