The Future Is Here: Compounding Medications to Treat the Symptoms of Parkinson’s Disease
This fall marked the date when actor Michael J. Fox leapt from 1985 to 2015 in the second film of the ‘Back to the Future’ trilogy. Many people have been talking about which predictions about the future came true and which did not—the one thing Fox hopes the next thirty years will be bring, even more than hoverboards, is a world in which Parkinson’s disease is truly a thing of the past. The actor famously revealed he suffers from the disease back in 1998, and since then awareness and resources for the disease have soared. Our understanding of the disease has changed profoundly over time, as has our ability to manage the symptoms through compounded medications.
Parkinson’s disease is a progressive disorder of the nervous system in which the brain slowly decreases the production of the neurotransmitter dopamine.1 This in turn disrupts the body’s motor system. The first sign of the disease is usually a tremor in the hands, legs, or face. Symptoms gradually spread to other parts of the body and after many years, patients may no longer be able to talk, walk, or even eat properly. There is currently no cure for this disease but ongoing research has revealed new understanding of how to manage the symptoms.
What Is the Current Understanding about Parkinson’s Disease?
At present, the cause of Parkinson’s disease remains elusive. What is known is that the disease is triggered when neurons stop producing necessary levels of dopamine, a chemical messenger essential for regular brain activity. It has long been thought that genetic mutations and/or environmental toxins can trigger the loss of neuron activity.2 The presence of Lewy bodies, clumps of proteins and other substances in the brain, are further thought to contribute to the onset and progression of the disease.
A recent study conducted at the University of Montreal suggests that diseased neurons essentially tire themselves to death trying to keep up with the energy needs generated by the constant need to produce dopamine.3 Trudeau’s team is already researching new drugs based on this discovery, specifically focused on repurposing a class of drugs already in use to treat diabetes.
What Medications Compounded for Parkinson’s Disease Are Available Now?
Oral medication currently remains the best way to treat Parkinson’s disease. The amount of research that is currently being conducted into new drugs is astounding and will inevitably lead to new and improved treatments. Still, patients do have a number of options now in terms of managing their symptoms and improving quality of life.4 The main types of medication include:
- Ledopova, a medication that is converted into dopamine in the body and is the most common drug used to treat Parkinson’s disease
- Dopamine agonists, which work by acting like dopamine in order to stimulate nerve cells
- MAO inhibitors, which prevent the breakdown of dopamine by inhibiting monoamine oxidase, the enzyme that breaks dopamine down
Combination therapy with anticholinergics or glutamate antagonists, such as amantadine, can also be successful.
Many patients ask about surgical options. Although surgery doesn’t offer a cure for Parkinson’s disease either, pharmacists can talk with patients about deep brain stimulation, in which an electrode is placed in a faulty motor circuit and stimulated with short electrical pulses. Patients at advanced stages of the disease have found these pulses help block some of the signals in the brain that cause motor abnormalities. Even with deep brain stimulation, however, medications compounded for Parkinson’s should not be discontinued.
With research into Parkinson’s disease at an all time high, pharmacists are well-poised to advise patients about the changing landscape of possible treatments. We should be on the lookout for new drugs in the pipeline, and we should let our patients know about the various clinical trials they can consider, many of which don’t get off the ground due to lack of patient enrollment. Parkinson’s is a slow moving disease, which means pharmacists and their patients can give careful consideration as to which trial, if any, might be appropriate for their individual cases. Pharmacists can also touch base regularly with subtle changes in symptoms, such as difficulty chewing or even swallowing medications, which may mean a change in treatment or treatment delivery is needed.
The future looks promising for a cure to Parkinson’s disease. Hopefully it will take much less than thirty years for this prediction to come true.
Parkinson’s disease starts off slowly but eventually progresses to the point where a patient has difficulty getting through simple daily life. It is important for patients to manage their symptoms as effectively as possible in order to maintain as high a quality of life as possible. Pharmaceutica North America offers safe and high-quality materials to make medications compounded for Parkinson‘s disease simply and effectively. Contact us today for more information.
- “NINDS Parkinson’s Disease Information Page,” October 18, 2015, http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm ↩
- “Parkinson’s disease,” July 7, 2015, http://www.mayoclinic.org/diseases-conditions/parkinsons-disease/basics/causes/con-20028488 ↩
- “Parkinson’s Disease May Be Caused By Brain Cells Overheating And Burning Out,” September 3, 2015, http://www.medicaldaily.com/parkinsons-disease-may-be-caused-brain-cells-overheating-and-burning-out-351198 ↩
- “Parkinson’s disease management, https://www.michaeljfox.org/understanding-parkinsons/living-with-pd/topic.php?medication&navid=medication ↩