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Prescribing medications for Parkinson's disease

02 March 2024
Volume 6 · Issue 3


Around 10 million people worldwide have Parkinson's disease and in the UK the estimated figure is 153000. The condition is characterised by motor symptoms including tremors, stiffness, slowness, balance problems and/or gait disorders, but sufferers can develop a wide range of associated psychological and physical problems. Treatment includes a combination of pharmacological and supportive physical therapies, supplied by a multidisciplinary team. As the condition progresses, medication regimens expand to include a combination of drug therapies. For those who do not benefit from pharmacological therapy deep brain stimulation surgery can be considered. Some people find that alternative therapies such as homeopathy, music and massage are useful additions to standard medical treatments. This article will give an overview of Parkinson's disease, including symptoms and diagnosis, and explore issues for consideration when prescribing common first-line Parkinson's medications.

The term ‘Parkinson's disease’ was first described by physician James Parkinson in 1817. It is defined as a ‘chronic, progressive neurodegenerative condition resulting from the loss of the dopamine-containing cells of the substantia nigra’ (National Institute for Health and Care Excellence (NICE, 2023). Also known as idiopathic Parkinson's disease, it is the most common neurological movement disorder in the world (Parkinson's UK, 2023a; World Health Organization (WHO), 2023). The prevalence of the disease has doubled in the last 25 years and this figure is predicted to increase by 23.9% annually (Parkinson's UK, 2023a). The current prevalence in the UK is expected to be over 172 000 by 2030, when it is anticipated that 1 in every 37 people will be diagnosed (Parkinson's UK, 2018).

While it can occur at any age, most cases develop in those aged 50 and over, and the overall incidence increases with age. Young-onset Parkinson's develops before the age of 50 (Parkinson's UK, 2018; NICE, 2023). It affects both men and women, but is most common in men, with prevalence up to 1.5 times higher (NICE, 2023). Research is ongoing to determine the possible causes, but environmental factors, including exposure to specific chemicals and air pollution, are thought to be risk factors. The condition can be genetically inherited, but the number of people who develop it solely due genetic history is small (WHO, 2023). Anyone with suspected Parkinson's should be referred untreated to a specialist (NICE, 2017).

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