2025 was a remarkable year for the Parkinson’s Foundation. Over the course of 365 days, we advanced Parkinson’s disease (PD) research while working hard to represent the one million people in the U.S. living with this neurodegenerative disease. We strengthened our connections among care partners and everyone serving the PD community.  

With your support, we launched new initiatives and vital PD resources, stayed fast in our commitment to improving PD care and research, and empowering the community through education and new resources.  

Thanks to YOU, here are the top 12 ways we made a difference this year:

1. Awarded more than $4.3 million in high-risk, high-reward research.

In a year when federal funding for disease research sharply declined, we significantly increased our investment in Parkinson’s research. We awarded more than $4.3 million across 44 grants. We are proud to fund scientists pursuing innovative studies across diverse areas of PD — driving the development of new therapies, treatments and ultimately a cure for the 10 million people worldwide living with this neurological disease.

Explore our ongoing research

2. Reached 30,000+ participants in our genetics study.

In 2025, PD GENEration: Powered by the Parkinson’s Foundation reached unprecedented numbers including: 

• Providing genetic testing and counseling to 30,000+ people with Parkinson’s, at no cost.

• Finding that approximately 12-13% of participants carry a genetic link to PD.

• Expanded study to a total of 77 testing sites worldwide and counting — adding sites in Mexico, Colombia, Chile, Peru and El Salvador.

We also launched an exciting new pilot program, PD Trial Navigator, to help advance PD GENEration’s goal of accelerating genetic-focused clinical trials. This program helps inform PD GENEration participants about Parkinson’s genetic trials they may qualify for based on their genetic results.

Enroll Now in PD GENEration

3. Launched new policy effort to accelerate PD treatments and care.

In 2025, we launched new policy initiatives aiming to empower the PD community through advocacy. Highlights include:

• Appointing Andi Lipstein Fristedt as our first Executive Vice President and Chief Strategy and Policy Officer to guide our policy efforts at the federal, state and local levels.

• Hosting a national roundtable on Parkinson’s care and innovation to identify national priorities to improve care for people with PD.

• Co-hosted the 2025 Parkinson's Policy Forum, where 250 people with PD, family members and advocates from 45 states gathered in Washington, D.C. to urge Congress to accelerate progress toward better treatments and a cure.

Sign up for our emails to keep up to date with advocacy efforts

4. Funded local Parkinson’s programs in 38 states.

We awarded more than $1 million in community grants for programs that help people living with PD across 38 states. Our 2025 grants fund local programs that provide exercise and educational support for people with PD and their care partners and address mental health needs. Since 2011, the Foundation has devoted more than $12.7 million in community-based programs, reaching a combined 81,000 people with PD and care partners.

 Pictured: Parkinson’s Foundation Community Grantee, Parkinson's Exercise Program For You, in Dana Point, CA, offers PD-tailored exercise programs. 

To find your nearest exercise or wellness class, visit your local chapter’s webpage or call our Helpline at 1-800-4PD-INFO (1-800-473-4636).

5. Appointed our first-ever Chief Medical Officer.

This year, we welcomed Sneha Mantri, MD, MS, as Chief Medical Officer of the Parkinson’s Foundation. A nationally recognized movement disorders specialist and educator, Dr. Mantri believes in getting to know her patients and personalizing their treatments. “I'm excited to bring that philosophy of care to this role and address the needs of people with Parkinson’s on a national scale,” she said.

Look out for virtual events featuring Dr. Mantri in 2026.

Learn more about Dr. Mantri here

6. Moved two Parkinson’s Virtual Biotech drugs into trials.

Parkinson’s Virtual Biotech is a research-driven investment fund we support alongside Parkinson’s UK. In 2025 we shared two exciting advances:

• Project ASPro-PD became the first Parkinson’s Virtual Biotech project to enter a large phase 3 trial, assessing whether ambroxol (a common cough medicine ingredient) can slow the progression of Parkinson’s. This trial is the closest to delivering a new treatment.

• A new drug from NRG Therapeutics, designed to repair the mitochondria that power brain cells, is advancing to clinical trials for Parkinson’s and ALS (amyotrophic lateral sclerosis). This progress was made possible through early investment from the Parkinson’s Virtual Biotech, proving how our venture philanthropy model fuels innovation — turning bold ideas into real possibilities for people living with Parkinson’s and making investments less risky for future funders.

Learn more about the Parkinson’s Virtual Biotech

7. Launched new resources to help people optimize their PD care.

We know that healthcare appointments for Parkinson’s can feel overwhelming. Which is why we published new content and tips dedicated to help people with PD and care partners advocate for their best care. Use our Steps to Prepare for a Parkinson’s Appointment worksheet for a step-by-step guide to choosing your top three appointment topics. 

Learn how to optimize your Parkinson’s care

8. Raised $263,000 on Parkinson’s Foundation Day of Giving.

Our incredible community came together and made our third annual Day of Giving the most successful so far, raising double the amount raised in 2024. Our steadfast supporters made this special day a success, raising awareness and funds to support our mission to make life better for people with Parkinson’s disease.

Give today

9. Facilitated 3,949 community service hours through Parkinson’s Ambassadors.

Volunteers are essential to our mission and help us localize our reach. This year, we trained 239 new Parkinson’s Foundation Ambassadors and brought all our volunteers together at our national Volunteer Leadership Summit.

Etana Soloman joined our People with Parkinson’s Advisory Council to add her voice and help represent young caregivers and people like her mother who are in the later stages of PD. “Being able to care for my mom is truly an honor”  Read her story.

Find a volunteer opportunity near you

10. Reached 8.6 million visits to Parkinson.org and expanded Spanish-language engagement.

Parkinson.org reached a record of 8.6 million visits, including 1.3 million visits to our Spanish content. Every page visit represents an opportunity to connect people with life-changing resources, digital events and actionable ways to help make life better for people with Parkinson’s.

Hispanic and Latino members of the PD community face distinct barriers to living well with Parkinson’s. In 2025, we published new Spanish pages on dementia, caregiving, vertigo, depression, hospital safety and more (explore these pages in English, too: dementia, caregiving, vertigo, depression, hospital safety).

Explore our Spanish pages

Visit Parkinson.org now

11. 20,000 participants raised more than $8.3 million through community fundraising events.

Parkinson’s Foundation community fundraisers raised an impressive $8.3 million to advance PD research, access to care and life-changing resources in 2025. Together, every person who participates in Moving Day, A Walk for Parkinson’s, Parkinson’s Champion and Parkinson’s Revolution bring us closer to a cure.

Two years after his diagnosis, Brooke Ramsey found Moving Day Columbus. For the last 14 years his family has raised more than $117,000 to help make life better for people with Parkinson’s. Read his story.

Find a Moving Day near you

Become a Parkinson’s Champions

Join us for Parkinson’s Revolution

12. Engaged with our audience through two awareness campaigns.

In April, we introduced the world to PAM, your guide to Parkinson’s Awareness Month. To raise PD awareness, PAM shared essential information, tips and resources about PD on our social media channels and website.

In April we: 

• Posted 5 new videos highlighting PD facts everyone should know.
• Reached 2+ million visits to Parkinson.org — our most page views in a single month!
• Earned 914,000 impressions across our social media posts

Follow us on social media to help spread Parkinson’s awareness

In November, for National Family Caregivers Month, we amplified the diverse experiences of caregiving through our Real Care. Anywhere. campaign. We provided tailored resources for three types of caregivers including those caring for someone living with Parkinson’s, those providing care from a distance and those managing PD alone.

Explore our care partner resources

We are setting bold goals for 2026 to create an even greater impact on the Parkinson’s community — and your support makes it possible.

Donate today

Over time, Parkinson’s disease (PD) medications can begin to lose their effectiveness. When this happens, deep brain stimulation (DBS) can be a promising treatment option for certain candidates. For DBS, electrodes are implanted into the brain that deliver controlled electrical stimulation that counteracts PD symptoms. 

Most DBS systems are designed to deliver consistent stimulation based on settings set and updated by physicians. However, a newer version called adaptive DBS (aDBS), recently approved by the U.S. Food and Drug Administration (FDA) for clinical use, monitors brain signals associated with PD symptoms in real time and adjusts stimulation automatically. This ability to auto-adjust stimulation has the potential to enhance DBS efficiency and minimize side effects, improving quality of life for those that use it.

Lauren Hammer, MD, PhD, recipient of a Parkinson’s Foundation Stanley Fahn Junior Faculty Award, is working to make aDBS even more effective by determining which types of brain signals offer the best information on how to adjust stimulation in response to symptoms. Current aDBS technology monitors low-frequency brain waves called “beta” signals, but Dr. Hammer believes that higher frequency “entrained-gamma” signals may be better for predicting and controlling PD symptoms. 

Learn more about DBS

 “This research aims to advance deep brain stimulation for Parkinson’s disease by identifying the most effective neural signal to guide adaptive DBS,” said Dr. Hammer. “Results could support expanding the set of neural signals used for clinical aDBS, enabling more effective and personalized treatment.” 

From her lab at the University of Pennsylvania, a Parkinson’s Foundation Center of Excellence, Dr. Hammer will first run an in-laboratory assessment where people with PD perform various movement tasks while their brain signals are monitored. This will provide data as to which type of signal — beta or entrained-gamma — offers a more accurate reflection for when PD symptoms like involuntary movements are occurring. 

Dr. Hammer will then take a small group of people with DBS for PD and upgrade them to aDBS for an at-home study. After participants are programmed for aDBS stimulation using both beta signals and entrained-gamma signals, they will switch weekly between these settings, recording how well their symptoms are controlled at home.   

At the end of the trial, Dr. Hammer and her team will have data to suggest which signal type guided the best aDBS experience for different types of people with PD.  

 “I’m deeply grateful to the Parkinson's Foundation for investing in early-career scientists and accelerating progress toward better care and a cure.” – Dr. Hammer 

“Receiving this Parkinson’s Foundation award is an incredible honor and an important milestone in my journey to improve the lives of people with Parkinson’s disease,” said Dr. Hammer. “As a new faculty member starting my own laboratory, this support comes at a critical time — helping me build the foundation for a research program focused on developing next-generation deep brain stimulation therapies. Funding at this early stage is vital to turning promising ideas into impactful treatments, and this award will help bridge the gap between training and long-term research support.” 

Meet more Parkinson’s researchers! Explore our My PD Stories featuring PD researchers.

La medicación desempeña un papel fundamental en el tratamiento de la enfermedad de Parkinson (EP), pero es sólo una parte de un plan de cuidados más amplio.  

El siguiente artículo se basa en una Charla con Expertos - Expert Briefing de la Parkinson's Foundation donde el Dr. Danny Bega explora cómo encajan los medicamentos en el cuidado integral y holístico del Parkinson. El Dr. Bega tiene una maestría en Ciencias, es profesor adjunto de Neurología, director médico y director del programa de residencia en Neurología del Centro de la Enfermedad de Parkinson y Trastornos del Movimiento de la Northwestern University Feinberg School of Medicine, un Centro de Excelencia de la Parkinson’s Foundation. También es director de los programas de las enfermedades de Huntington y Wilson en Northwestern. 

Comprender la conexión entre la dopamina y el Parkinson 

El Parkinson es un trastorno progresivo relacionado con la disminución de los niveles de dopamina, una sustancia química cerebral que influye en el movimiento, la memoria y muchos otros procesos vitales del organismo. Otras sustancias químicas del cerebro, como la norepinefrina y la serotonina, también pueden verse afectadas en la enfermedad de Parkinson e influir en los síntomas.  

A medida que avanza el Parkinson, el número de células cerebrales que producen dopamina sigue disminuyendo y las células restantes luchan por almacenar y liberarla. Esto provoca lentitud de movimientos, temblores, rigidez y otros síntomas motores. También puede causar diversos síntomas no motores, como estreñimiento, pérdida del olfato y cambios en el pensamiento. 

Manejo del Parkinson’s 

El Parkinson es una enfermedad compleja. No existe un tratamiento estándar. Sin embargo, los medicamentos —junto con el ejercicio, la atención integral, una dieta nutritiva y prácticas de atención plena— pueden controlar los síntomas del Parkinson y ayudarle a vivir bien.  

Establecer una rutina de ejercicio poco después del diagnóstico puede ayudar a ralentizar la progresión de la enfermedad y mejorar el movimiento, la fuerza, el equilibrio y el estado de ánimo. También puede ayudarle a dormir mejor. Mantenerse social e interactuar puede reducir la sensación de soledad.  

Su equipo de atención es igualmente importante. Busque profesionales médicos expertos en Parkinson, incluyendo un neurólogo, un terapeuta del habla y el lenguaje, un fisioterapeuta y un terapeuta ocupacional, un trabajador social y otros profesionales de la salud, para que le ayuden a controlar los síntomas de la EP. No deje de acudir a las revisiones periódicas. 

El papel de los medicamentos 

La mayoría de los medicamentos para el Parkinson mejoran los síntomas aumentando la dopamina en el cerebro o actuando como la dopamina. La levodopa es el fármaco más eficaz para tratar los síntomas del Parkinson. En el transcurso del Parkinson, la mayoría de las personas tomarán levodopa en algún momento.  

La ansiedad y la depresión también pueden ser frecuentes en el Parkinson y afectar al bienestar incluso más que los síntomas motores. Tratar estos síntomas mediante una combinación de medicamentos, como un ISRS, un IRSN o la mirtazapina, —un antidepresivo tricíclico—, junto con terapia, control del estrés y mantener la actividad física, puede reducir la discapacidad significativamente.  

Las personas recién diagnosticadas de Parkinson a menudo se preguntan cuándo deben empezar a tomar la medicación. Los estudios demuestran que esperar no tiene beneficios. La mayoría de los médicos concuerdan en que debe empezar a tomar la medicación cuando los síntomas se vuelvan molestos.  

Dado que no cada persona experimenta la EP de forma única, los tratamientos varían de una persona a otra, al igual que el ritmo de progresión. Sin embargo, conocer los estadios típicos del Parkinson puede ayudarle a anticiparse a los cambios: 

• En los primeros cinco años después del diagnóstico, es posible que los síntomas no afecten su vida diaria significativamente. Su médico podría recomendarle un ensayo clínico. La participación en la investigación del Parkinson podría darle acceso temprano a nuevos tratamientos, mejorar la atención y sentar las bases para una cura.  

• En un plazo de uno a diez años, conforme los síntomas empiezan a interferir con las actividades, la mayoría de las personas con Parkinson pueden esperar una respuesta duradera y constante a la medicación.  

• Entre cinco y 20 años después del diagnóstico, al cerebro le resulta cada vez más difícil conservar dopamina. La respuesta de su cuerpo a la levodopa puede volverse más corta y menos eficaz. Esto puede provocar fluctuaciones motoras: periodos en "on", cuando la medicación funciona bien, y periodos en "off", cuando la medicación deja de hacer efecto y los síntomas reaparecen. Es importante trabajar de cerca con su médico para ajustar el tratamiento y encontrar lo que mejor se adapte a usted. 

• Después de 10 o más años de vivir con Parkinson, las personas pueden experimentar problemas más importantes. Algunas personas pueden desarrollar importantes problemas de memoria y pensamiento. Problemas de equilibrio, caídas y congelamiento (la incapacidad temporal para moverse) también puede volverse un problema. Su médico puede hablarle de ajustes de la medicación o terapias farmacológicas o mandarlo a ver a un profesional médico adecuado para sus necesidades, que puede ser un neuropsicólogo, un psiquiatra, un terapeuta del habla y el lenguaje o un terapeuta ocupacional. 

Tipos de medicamentos utilizados en el Parkinson 

Es frecuente que las personas con Parkinson tomen una variedad de medicamentos, en distintas dosis y momentos del día, para manejar los síntomas. Esto puede incluir: 

Agonistas de la dopamina: al principio, los fármacos que estimulan la dopamina en el cerebro, como el pramipexol, el ropinirol y la rotigotina, a menudo pueden tratar los síntomas motores del Parkinson. Los agonistas de la dopamina presentan menos riesgo de discinesias, movimientos erráticos involuntarios que suelen comenzar tras unos años de tratamiento con levodopa.  

Los efectos secundarios pueden incluir náuseas, mareos, somnolencia, confusión y trastornos del control de los impulsos, como compras compulsivas, juegos de azar, comer en exceso y los impulsos sexuales. Los estudios muestran que un 28% de las personas con Parkinson dejan de tomar agonistas de la dopamina debido a los efectos secundarios, mientras que un 40% necesita añadir otra medicación en un plazo de dos años. 

Levodopa: la levodopa, el fármaco más eficaz para los síntomas motores del Parkinson, sustituye a la dopamina en el cerebro. Suele administrarse en combinación con el fármaco carbidopa para reducir las náuseas, un efecto secundario frecuente. Tomar levodopa con las comidas también puede reducir las náuseas, pero las proteínas pueden interferir en la eficacia del fármaco. Alrededor de un 2% de las personas dejan de tomar levodopa debido a los efectos secundarios, mientras que un 15% necesita añadir otra medicación a los dos años.  

Las discinesias, también relacionadas con la levodopa, pueden controlarse a menudo mediante un ajuste de la dosis o mediante tratamiento directo, utilizando un medicamento llamado amantadina. Funciona bloqueando el NMDA, una sustancia química que provoca movimientos extras. La amantadina de liberación inmediata también se utiliza a veces sola para los síntomas motores del Parkinson. Existe un mayor riesgo de confusión y alucinaciones con el uso de amantadina en personas de más de 75 años. También puede asociarse a hinchazón de piernas, alteraciones de la piel y otros efectos secundarios.  

Anticolinérgicos: Los medicamentos trihexifenidilo y benztropina se utilizan a veces para mejorar el temblor o las distonías (calambres dolorosos y sostenidos). Actúan bloqueando la acetilcolina, una sustancia química del cerebro relacionada con el movimiento. Sin embargo, su uso debe evitarse en personas de 70 años o más debido al riesgo de confusión y alucinaciones. Los anticolinérgicos también pueden asociarse a visión borrosa, sequedad de boca, estreñimiento y retención urinaria. 

Algunos de los medicamentos que su médico podría considerar para mejorar los efectos de la levodopa son: 

Inhibidores de la MAO-B: los inhibidores de la monoaminooxidasa B rasagilina, selegilina y safinamida ponen más dopamina a disposición del cerebro. Estos medicamentos pueden utilizarse solos o en combinación con la levodopa para aumentar su eficacia. Los inhibidores de la MAO-B suelen tolerarse bien, pero un 70% de las personas que los toman solos para el Parkinson necesitarán añadir otra medicación a los dos años. 

Inhibidores de la COMT: medicamentos como la entacapona y la opicapona aumentan la levodopa disponible en el cerebro al bloquear la enzima catecol-O-metil transferasa.  

Antagonista del receptor A2A: la istradefilina, un antagonista de la adenosina A2A, bloquea la adenosina en los receptores A2A del cerebro para reducir el tiempo en "off" de la levodopa. 

La levodopa inhalada se utiliza a menudo con la levodopa, según sea necesario, para el tiempo en "off" repentino. La apomorfina inyectable también puede utilizarse a demanda, para el alivio en tiempos en "off". Ambos medicamentos pueden aumentar el riesgo de discinesias. 

Es importante trabajar con su médico para encontrar el equilibrio adecuado para usted. Su médico puede aumentar o disminuir su dosis de levodopa con base en sus síntomas. Por ejemplo, el temblor, la rigidez o los problemas de movilidad podrían beneficiarse de un aumento de la levodopa. Sin embargo, las alucinaciones, la confusión y la baja presión arterial podrían mejorar con una disminución de la levodopa. 

También existen estrategias y medicamentos para controlar el babeo, el goteo nasal, los problemas de sueño, los problemas intestinales, los cambios en el pensamiento y otros desafíos del Parkinson. 

¿Qué pasa si no funciona la levodopa? 

Si está tomando levodopa pero no obtiene beneficios, hable con su médico. Estas son algunas preguntas que puede hacer: 

• ¿El síntoma que le molesta no responde bien a la levodopa? ¿Podría estar relacionado con otro problema de salud?  

• ¿Le convendría que lo manden a ver a un terapeuta de rehabilitación u otro profesional médico? 

• ¿Puede haber algo que esté interfiriendo en la absorción de la medicación? Algunas personas experimentan menos beneficios cuando toman levodopa con una comida alta en proteínas. 

• ¿Tiene alguna condición que se parezca al Parkinson? 

También es importante discutir si es necesario ajustar la dosis. Por ejemplo, los efectos del Sinemet, una forma de levodopa, sólo duran poco tiempo: a los 90 minutos, la mitad ha desaparecido. Su médico puede ajustar el horario y la dosis de levodopa, utilizar una formulación de acción más prolongada o recomendar tomar la medicación 30 minutos antes o 60 minutos después de comer. 

Terapias avanzadas 

Si se vuelve difícil controlar las fluctuaciones motoras ajustando la medicación oral, existen otras opciones para mejorar la absorción de la medicación y reducir el tiempo en "off":  

• La terapia con Duopa suministra carbidopa-levodopa en gel directamente al intestino a través de un tubo colocado quirúrgicamente.  

• La terapia con foscarbidopa y foslevodopa (Vyalev) utiliza una bomba para administrar de forma constante una forma de levodopa bajo la piel a través de un pequeño tubo llamado cánula. Se utiliza una aguja para colocar la cánula. 

• La terapia continua con apomorfina (Onapgo) utiliza una bomba para administrar apomorfina de forma continua a través de una fina aguja colocada bajo la piel.  

Estos medicamentos requieren ajustes en el estilo de vida, instrucción para su uso y un compromiso con el buen cuidado de la piel para reducir el riesgo de irritación e infecciones. 

Otras opciones además de la medicación 

En ocasiones, los síntomas de Parkinson más avanzados pueden beneficiarse de otras estrategias de tratamiento, como la estimulación cerebral profunda (ECP, o DBS, por sus siglas en inglés), que consiste en implantar quirúrgicamente un generador de impulsos eléctricos conectado a electrodos colocados en el cerebro para tratar los síntomas motores del Parkinson y algunos síntomas no motores.  

La ECP podría ser considerada para alguien que:  

• vive con la enfermedad de Parkinson clásica  

• tiene síntomas que responden a la levodopa  

• experimenta frecuentes fluctuaciones motoras y temblores, a pesar de una dosificación constante de la medicación 

• tiene discinesias molestas 

Tras la ECP, muchas personas pueden reducir su medicación y seguir experimentando una reducción de los síntomas de la EP. La reducción de la dosis de medicamento puede llevar a menos discinesias. 

El ultrasonido focalizado, una terapia no invasiva, no requiere una incisión quirúrgica. Durante el procedimiento, se dirigen ondas sonoras de alta frecuencia a una zona específica del cerebro relacionada con el temblor para aliviar el temblor de la enfermedad de Parkinson. A diferencia de la terapia de ECP, que es ajustable y reversible, los cambios por ultrasonido focalizado son permanentes. 

Si tiene preguntas acerca de las opciones de tratamiento de la EP, comuníquese con nuestra Línea de Ayuda al 1-800-4PD-INFO (473-4636) opción 3 para español o en Helpline@Parkinson.org. 

Aprenda más 

Explore nuestros recursos acerca de medicamentos para tratar los síntomas del Parkinson:  

•  Visite nuestra página web sobre “Medicamentos recetados”. 

• Descargue nuestra hoja informativa “Entendiendo la Estimulación Cerebral Profunda (ECP)”. 

•  Escuche nuestro pódcast “Entendiendo el horario del medicamento y cómo prepararse para la cita con el neurólogo”. 

Medication plays a key role in managing Parkinson’s disease (PD), but it’s only one part of a broader care plan.  

The following article is based on a Parkinson’s Foundation  Expert Briefing  exploring how medications fit into integrated, holistic Parkinson’s care, hosted by Danny Bega, MD, MSCI, associate professor of neurology, medical director and director of the Parkinson's Disease & Movement Disorders Center neurology residency program at Northwestern University Feinberg School of Medicine, a Parkinson's Foundation Center of Excellence. Dr. Bega is also the director of the Huntington's and Wilson’s diseases programs at Northwestern. 

Understanding the Dopamine-Parkinson’s Connection 

Parkinson’s is a progressive disorder linked to declining levels of dopamine, a brain chemical that influences movement, memory and many other vital body processes. Other brain chemicals, including norepinephrine and serotonin, can also be impacted in Parkinson's disease and influence symptoms.  

As Parkinson’s advances, the number of brain cells making dopamine continues to decrease, and remaining cells struggle to store and release it. This leads to slowness of movement, tremor, rigidity and other motor symptoms. It can also cause various non-motor symptoms, such as constipation, loss of smell and thinking changes. 

Managing Parkinson’s 

Parkinson’s is a complex disease. There is no standard treatment. However, medications — along with exercise, comprehensive care, a nutritious diet and mindfulness practices — can manage Parkinson’s symptoms and help you live well.  

Establishing a regular exercise routine soon after diagnosis may help slow disease progression and can improve movement, strength, balance and mood. It can also help you sleep better. Staying social and engaged can reduce feelings of loneliness.  

Your care team is equally important. Look for healthcare professionals with expertise in Parkinson’s, including a neurologist, speech-language pathologist, physical and occupational therapist, social worker and other healthcare professionals, to help manage your PD symptoms. Be sure to attend regular checkups. 

The Role of Medication 

Most Parkinson’s medications work to improve symptoms by either increasing dopamine in the brain or acting like dopamine. Levodopa is the most effective drug for managing Parkinson’s symptoms. During the course of Parkinson’s, most people will take levodopa at some point.  

Anxiety and depression can also be common in Parkinson’s and can impact well-being even more than motor symptoms. Treating these symptoms using a combination of medication, such as an SSRI, SNRI or mirtazapine — a tricyclic antidepressant drug — along with therapy, stress management and staying active, can significantly decrease disability.  

People newly diagnosed with Parkinson’s often wonder when to begin prescription medication. Studies show there is no benefit in holding off. Most doctors agree you should start medication when symptoms begin to bother you.  

Because no two people experience PD in exactly the same way, treatments vary from person to person, as does the rate of progression. However, knowing the typical stages of Parkinson’s can help you anticipate changes: 

• In the first five years following diagnosis, you may find symptoms don’t significantly impact your daily life. Your doctor might recommend a clinical trial. Participation in Parkinson’s research can potentially give you early access to new treatments, improve care and lay the foundation for a cure.  

• Within one to 10 years, as symptoms begin to interfere with activities, most people with Parkinson’s can expect a long-lasting, steady response to medication.  

• Between five and 20 years after diagnosis, it becomes increasingly harder for the brain to store dopamine. Your body’s response to levodopa can become shorter and less efficient. This can lead to motor fluctuations — "on" periods, when medication works well, and "off" periods, when medication wears off and symptoms return. It is important to work closely with your doctor to adjust your treatment and find what works best for you. 

• After 10 or more years of living with Parkinson’s, a person can experience more significant issues. Some people can develop significant memory and thinking problems. Trouble with balance, falls and freezing, a temporary inability to move, can also become an issue. Your doctor can discuss medication adjustments or drug therapies or provide a referral to the right healthcare professional for your needs, which might include a neuropsychologist, psychiatrist, or a speech or occupational therapist. 

Types of Medications Used in Parkinson’s 

It can be common for people with Parkinson’s to take a variety of medications, at different doses and different times of day, to manage symptoms. This can include: 

Dopamine agonists: Early on, drugs that stimulate dopamine in the brain, such as pramipexole, ropinirole and rotigotine, can usually treat Parkinson’s movement symptoms. Dopamine agonists pose less risk for dyskinesia — involuntary erratic movements that usually begin after a few years of levodopa treatment.  

Side effects can include nausea, dizziness, sleepiness, confusion and impulse control disorders, such as uncontrolled shopping, gambling, eating and sexual urges. Studies show 28% of people with Parkinson’s stop taking dopamine agonists due to side effects, while 40% need to add another medication within two years. 

Levodopa: Levodopa, the most effective drug for Parkinson’s movement symptoms, replaces dopamine in the brain. It is usually given in combination with the drug carbidopa to reduce nausea, a common side effect. Taking levodopa with meals can also reduce nausea, but protein may interfere with the drug’s effectiveness. About 2% of people taking levodopa stop due to side effects, while 15% need to add another medication within two years.  

Dyskinesia, also linked to levodopa, can often be managed by a dose adjustment or through direct treatment, using a medication called amantadine. It works by blocking NMDA, a chemical that causes extra movement. Immediate-release amantadine is also sometimes used alone for Parkinson’s movement symptoms. There is an increased risk of confusion and hallucinations with amantadine use in people over 75. It can also be associated with leg swelling, skin changes and other side effects.  

Anticholinergics: The medications trihexyphenidyl and benztropine are sometimes used to improve tremor or dystonia — painful, sustained cramping . They work by blocking acetylcholine, a brain chemical tied to movement. However, their use should be avoided in people 70 and older due to the risk of confusion and hallucinations. Anticholinergics can also be associated with blurred vision, dry mouth, constipation and urinary retention. 

Medications your doctor might consider to improve the effects of levodopa include: 

MAO-B inhibitors: Monoamine oxidase-B inhibitors rasagiline, selegiline and safinamide make more dopamine available to the brain. These medications can be used alone or in combination with levodopa to extend effectiveness. MAO-B inhibitors are generally well tolerated, but 70% of people taking them alone for Parkinson’s will need to add another medication within two years. 

COMT inhibitors: Medications such as entacapone and opicapone increase available levodopa in the brain by blocking the catechol-O-methyl transferase enzyme.  

A2A receptor antagonist: Istradefylline, an adenosine A2A antagonist, blocks adenosine at A2A receptors in the brain to reduce levodopa “off “time. 

Inhaled levodopa is often used with levodopa, as needed, for sudden “off” time. Injectable apomorphine can also be used on demand, for “off” time relief. Both medications can increase the risk of dyskinesia. 

It is important to work with your doctor to find the right balance for you. Your doctor might increase or decrease your levodopa based on your symptoms. For example, tremor, stiffness or mobility issues might benefit from an increase in levodopa. However, hallucinations, confusion and low blood pressure might improve with a decrease in levodopa. 

There are also strategies and medications to manage drooling, runny nose, sleep issues, gut issues, thinking changes and other Parkinson’s challenges. 

What if levodopa doesn’t seem to be working? 

If you are taking levodopa but aren’t seeing benefits, talk to your doctor. Here are some questions to ask: 

• Is the symptom troubling you one that doesn’t respond well to levodopa? Could it be related to another health issue?  
• Would you benefit from a referral to a rehabilitation therapist or another health professional? 
• Could something be interfering with how your body is absorbing medication? Some people experience less benefit when taking levodopa with a high-protein meal. 
• Do you have a condition that mimics Parkinson’s? 

It is also important to discuss whether your dose needs to be adjusted. For example, the effects of Sinemet, a form of levodopa, only last a short time — after 90 minutes half of it is gone. Your doctor might adjust the timing and dose of levodopa, use a longer-acting formulation or recommend taking your medications 30 minutes before or 60 minutes after eating a meal. 

Advanced Therapies 

If it becomes difficult to control motor fluctuations by adjusting oral medications, there are other options to improve medication absorption and reduce “off” time:  

• Duopa therapy delivers carbidopa-levodopa gel directly to your intestine through a surgically placed tube.  

• Foscarbidopa and foslevodopa (Vyalev) therapy uses a pump to steadily deliver a form of levodopa under the skin through a small tube called a cannula. A needle is used to place the cannula. 

• Continuous apomorphine therapy (Onapgo) uses a pump to deliver continuous apomorphine through a fine needle placed under the skin.  

These medications require lifestyle adjustments, training to use and a commitment to good skin care to reduce the risk of irritation and infections. 

Options Beyond Medication 

More advanced Parkinson’s symptoms can sometimes benefit from other treatment strategies, such as deep brain stimulation (DBS) — which involves surgically implanting an electrical pulse generator connected to electrodes placed in the brain to address Parkindeep-brainson’s movement symptoms and some non-movement symptoms.  

DBS might be considered for someone who:  

• lives with classic Parkinson’s disease  

• has symptoms that respond to levodopa  

• experiences frequent motor fluctuations and tremor, despite consistent medication dosing 

• has bothersome dyskinesia 

Following DBS, many people can reduce their medications and still experience a reduction of their PD symptoms. The reduction in dose of medication can lead to decreased dyskinesia. 

Focused ultrasound, a non-invasive therapy, does not require a surgical incision. During the procedure, high-frequency sound waves are aimed at a specific area of the brain connected to tremor to relieve Parkinson’s tremor. Unlike DBS therapy, which is adjustable and reversible, focused ultrasound changes are permanent. 

If you have questions about PD treatment options, contact our Helpline at 1-800-4PD-INFO (473-4636) or Helpline@Parkinson.org. 

Learn More 

Explore our resources about medications to treat symptoms of Parkinson’s:  

• Download our book Medications: A Treatment Guide to Parkinson’s Disease 

• Watch Understanding Deep Brain Stimulation (DBS) 

• Read The Latest in Parkinson’s Medications: Taking a Personalized Approach 

Levodopa, which helps with the movement symptoms of Parkinson’s, tends to work less well over time, especially for women. 

Parkinson's disease (PD) is a condition that gets worse over time, impacting the nervous system. It's caused by the gradual death of brain cells that produce dopamine, a crucial chemical messenger for controlling movement. When these cells are lost and dopamine levels drop, people with Parkinson's begin to experience noticeable symptoms like shaking or tremors, muscle stiffness, a general slowness of movement and problems with balance. 

A primary treatment for these movement symptoms is the drug levodopa. The body converts this medication into dopamine, helping to replenish the brain's supply. By doing so, levodopa can significantly reduce the physical challenges of the disease and improve a person's daily life. 

However, for many individuals with Parkinson's, the effectiveness of levodopa can begin to diminish between doses. In other words, it starts "wearing off." Patients may notice their movement symptoms, such as tremors and stiffness, gradually returning before their next scheduled dose. 

Parkinson’s also impacts men and women differently. Men are estimated to be 1.5 times more likely to develop Parkinson’s. Women with Parkinson's are often diagnosed at a later age and may have slightly different symptoms. These differences between men and women with Parkinson’s could be due to a variety of factors, including hormonal differences and genetics. 

To better understand how these gender differences impact experience with levodopa, a recent study tracked 216 individuals with Parkinson's over a two-year period. The goal was to investigate whether men and women experience levodopa wearing off at different rates and to examine the symptoms that occur while on this medication. 

Study Results 

Participants included 139 men and 77 women with Parkinson’s who began taking levodopa for the first time at the start of the study. After two years in the study, almost 65% of women experienced symptom fluctuations, or times when the medication's effects seem to "wear off" before the next dose is due. This was compared to about 53% of men. This suggests that for many women, the medication was less effective in managing symptoms and did not feel as consistent over time. 

In addition, more women in the study developed dyskinesia, a side effect of levodopa that leads to involuntary, uncontrolled movements. About 14% of women developed dyskinesia compared to only 5% of men. Taken together, these results suggest that there may be differences in how levodopa is processed in the body between men and women. 

The study concluded that being female was the strongest predictor for both the wearing-off effect and dyskinesia after taking levodopa for two years. This indicates that gender is an important factor when considering how a person might respond to this medication. 

Highlights 

• The study followed 139 men and 77 women with Parkinson’s for two years after they started taking levodopa for the first time.  

• During the two-year study period, 65% of women experienced times when the medication's effects seemed to "wear off" before the next dose. This was compared to about 53% of men. 

• During the study, about 14% of women developed dyskinesia, compared to only 5% of men.  

• The study concluded that female gender predicted the development of motor fluctuations and dyskinesia more than any other factor.  

What does this mean? 

Women’s experiences have been historically underrepresented in PD research. This study adds to increasing evidence that men and women often experience various aspects of PD differently, including in their response to the PD medication levodopa. Specifically, these results indicate that women may be more likely to have worse responses to levodopa treatment over time compared to men. However, the reasons for these differences between men and women are still unknown. Additionally, it is common for both men and women to have breakthrough symptoms on levodopa over time.  

What do these findings mean to people with PD right now? 

Knowing that men and women may react differently to prolonged levodopa treatment can help healthcare providers develop more effective treatment plans for patients. While more research needs to be done, the findings from this study suggest that more tailored, “gender-oriented” treatment recommendations may be needed. If you are struggling with symptoms related to levodopa treatment, talk to your doctor to discuss your treatment plan.  

Learn More 

The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about PD and the topics in this article through our below resources, or by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions. 

• Levodopa 
• PD and Medication: Advancing Treatment 
• Episode 6: New Levodopa Delivery Methods for Parkinson’s