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Secondary parkinsonism - Treatment

Alternative Names

Parkinsonism - secondary

Treatment:

Treatment is aimed at controlling symptoms. If the symptoms are mild, no treatment may be needed.

If the condition is caused by a medication, the benefits of the medication should be weighed against the severity of symptoms. Medications should be stopped or changed if the risks outweigh the benefits.

Treating underlying conditions such as stroke or infections can reduce symptoms.

Medications may be used if symptoms interfere with the ability to perform daily activities. The medication, dose, timing, or combination of medications may need to be adjusted as symptoms change.

Many of the medications used to treat this condition can cause severe side effects. Monitoring and follow-up by the health care provider are important. Secondary parkinsonism tends to be less responsive to medical therapy than Parkinson's disease. However, medications are worth trying if the cause of the condition is not treatable.

Medications used to treat symptoms of Parkinson's disease are:

  • Levodopa (L-dopa), Sinemet, levodopa and carbidopa (Altamet)
  • Pramipexole (Mirapex), ropinirole (Requip), bromocriptine (Parlodel)
  • Selegiline (Eldepryl, Deprenyl), rasagiline (Azilect)
  • Amantadine or anticholinergic medications (to reduce early or mild tremors)
  • Entacapone (to prevent the breakdown of levodopa)

For a more detailed description of treatment, see Parkinson's disease.

Expectations (prognosis):

What will happen varies and depends on the cause of the disorder. If the disorder is caused by medications, it may be treatable. All other causes are not reversible and tend to get worse over time.

Complications:

  • Difficulty performing daily activities
  • Difficulty swallowing (eating)
  • Disability (varying degrees)
  • Injuries from falls
  • Side effects of medications

Side effects from loss of strength (debilitation):

Calling your health care provider:

Call your health care provider if:

  • Symptoms of secondary parkinsonism develop, come back, or get worse
  • New symptoms appear, including:
    • Changes in alertness, behavior, or mood
    • Delusional behavior
    • Dizziness
    • Hallucinations
    • Involuntary movements
    • Loss of mental functions
    • Nausea or vomiting
    • Possible side effects of medications
    • Severe confusion or disorientation

Discuss the situation with your health care provider if you are unable to care for the person at home (after treatment begins).

  • Reviewed last on: 10/4/2010
  • Daniel Kantor, MD, Medical Director of Neurologique, Ponte Vedra, FL and President of the Florida Society of Neurology (FSN). Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Lang A. Parkinsonism. In: Goldman L, Ausiello D. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 433.

Lang AE. When and how should treatment be started in Parkinson disease? Neurology. 2009;72(7 Suppl):S39-43.

Lewitt PA. Levodopa for the treatment of Parkinson's disease. N Engl J Med. 2008;359(23):2468-76.

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