Levodopa is the most common and effective medication for Parkinson’s disease. Other drugs are also available and may help alleviate symptoms of the condition, like tremors and movement limitations.
Medically reviewed by Alisha D. Sellers, BS Pharmacy, PharmD
Parkinson’s disease medications aim to improve mobility challenges, chronic pain, and motor functionality caused by the condition.
People with Parkinson’s disease may have a deficit in dopamine, a natural hormone and neurotransmitter involved in memory, coordination, movement, and sensations of pleasure and satisfaction. Most Parkinson’s disease medications aim to stimulate the natural production of dopamine or mimic its effects.
Your health team may need to assess your symptoms and medical history first to determine the best medication for your symptoms.
This article discusses the medications doctors commonly prescribe to treat Parkinson’s disease, side effects that may occur, and other possible management approaches for the condition.
Levodopa
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Levodopa (L-Dopa) is considered the most effective medication for Parkinson’s disease mobility challenges. So it is often the first line of treatment, particularly for more advanced stages of the condition.
This drug is converted in your brain into dopamine, substituting the typical dopamine deficit people with Parkinson’s disease experience. This, in turn, improves bradykinesia, which is the slowness of movement that characterizes Parkinson’s disease.
Taking levodopa may also slow down the progression of the condition.
Your health team will likely recommend you take carbidopa alongside levodopa to prevent your body from breaking down levodopa before it reaches your brain. Most Parkinson’s disease medications already combine the two drugs.
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Dopamine agonists stimulate the areas of the brain that are affected by dopamine. In other words, these drugs mimic the way the hormone works and trick your brain into thinking it has enough dopamine.
Even though both dopamine agonists and levodopa aim to compensate for dopamine deficit in people with Parkinson’s disease, levodopa does convert into dopamine in your body, while agonists do not. Instead, they behave like dopamine.
Doctors typically prescribe dopamine agonists when you first start showing symptoms of Parkinson’s disease, although they may still be effective later on. These drugs are also indicated for restless legs syndrome, whether it is related or not to Parkinson’s disease.
Postponing levodopa therapy in younger people may help avoid some of the side effects associated with long-term levodopa treatment. Also, dopamine agonists last longer than levodopa in the body, so you do not need to take them as frequently.
Dopamine agonists come in different formulas. Your health team will recommend the most effective type for you.
MAO-B is an enzyme that breaks down dopamine and other chemicals in your body. When you take MAO-B inhibitors, more dopamine is available to your brain.
MAO-B inhibitors can help improve symptoms of Parkinson’s disease, particularly those related to involuntary movements.
Your health team may prescribe MAO-B inhibitors during the early stages of Parkinson’s disease or alongside other medications, such as levodopa.
Anticholinergic medications block acetylcholine, a chemical naturally produced in your brain involved in memory, arousal, and involuntary movements.
Anticholinergics may be used as monotherapy or alongside other medications to manage Parkinson’s disease symptoms like dystonia (painful muscle contractions) and tremors.
Benztropine (Cogentin) and trihexyphenidyl HCL (Artane) are anticholinergic drugs for Parkinson’s disease.
Amantadine
Amantadine is an antidyskinetic drug, which means it treats involuntary or erratic movements and muscle spasms. It is also an antiviral medication commonly used to treat influenza A.
This Parkinson’s disease medication improves low dopamine levels and low levels of acetylcholine in certain areas of your brain. This may alleviate tremors, muscle stiffness, rigidity, and bradykinesia.
Health professionals may recommend taking amantadine alongside levodopa.
Amantadine is available in:
immediate-release tablets
extended-release tablets
solution
capsules
Amantadine is available under the following brand names:
Most treatments for Parkinson’s disease aim to balance low levels of dopamine in your brain. Adenosine A2A antagonists may have the same effects, although they work differently.
Adenosine A2A antagonists block adenosine receptors, which are neighbors to the dopamine receptors in your brain. Instead of converting into dopamine or mimicking its effects, these drugs lead to the same improvement in symptoms by reducing adenosine production.
Adenosine is a natural chemical involved in the management and conversion of energy within your cells.
Some evidence suggests these medications may prevent neurological loss and stop the progression of motor function challenges in Parkinson’s disease.
More research is needed to confirm the full potential of adenosine A2A antagonist drugs for this and other conditions.
Side effects of Parkinson’s disease medications
Istradefylline (Nourianz) is a common adenosine A2A antagonist medication used to treat Parkinson’s disease.
These are some of the most common side effects of medications used to treat Parkinson’s disease:
Parkinson’s disease medication
Side effect
levodopa
loss of appetite nausea and vomiting lightheadedness decreased blood pressure mental confusion visual hallucinations dyskinesia sleepiness or sudden sleep attack (rare) low impulse control (rare)
decreased blood pressure lightheadedness leg swelling and/or discoloration sleepiness or sudden sleep attacks during the daytime mental confusion visual hallucinations dyskinesia development of compulsive behaviors
catechol-O-methyl transferase (COMT) inhibitors
mental confusion visual hallucinations changes in the color of urine (reddish brown or rust-colored) diarrhea increased chance of side effects of levodopa, such as dyskinesia
Parkinson’s disease medications often aim to balance low levels of dopamine in the brain. Levodopa is considered the most effective medication to treat this condition. However, if used for a long period, it may cause severe side effects, including slowness of movement.
Other common medications used to treat Parkinson’s disease include dopamine agonists, MAO-B inhibitors, and adenosine A2A antagonists.
You can discuss your symptoms with your health team to determine the best medication for you.
Most Parkinson’s disease medications cause mild to moderate side effects, like nausea, mental confusion, and hallucinations.
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Mori A, et al. (2022). The pharmacological potential of adenosine A2A receptor antagonists for treating Parkinson's disease [Abstract]. https://pubmed.ncbi.nlm.nih.gov/35408767/
