Parkinson's disease is always progressing.Your therapies will need to keep up.

What is Parkinson's disease?

Parkinson's disease is a movement disorder that affects approximately one million people in the US and over ten million people worldwide.1,2 The disease is both progressive—meaning it advances over time—and degenerative, because it is characterized by a continuous decline of dopamine-producing cells in the motor region of the brain.

Dopamine is an important chemical substance that the brain uses to regulate movement. Its decline in Parkinson's disease reduces patients' ability to control or initiate movement, resulting in symptoms like tremor, slow movement, rigidity and postural instability.

What causes Parkinson's disease?

Even though Parkinson's disease was first described over 200 years ago, its exact cause is still unknown. A few studies suggest that it may be genetic, but only about 15 percent of people with Parkinson's disease have a family history of it. Most scientists believe that it's caused by a complex combination of genetic and environmental factors.3

Parkinson's disease symptoms

Motor symptoms

Motor symptoms can make the activities of everyday life challenging.

  • Tremor

  • Slowed

  • Rigidity

  • Postural

  • Shuffle steps

  • Speech

Non-motor symptoms

Even though Parkinson's disease is a movement disorder, the non-motor symptoms can have just as big an impact on your quality of life.

  • Decreased
    sense of smell

  • Depression or
    mood problems

  • Pain

  • Insomnia

  • Bladder or bowel

  • Fatigue

American Parkinson's Disease Association "Look Closer" Video

APDA's public service announcement, Look Closer, was made to help expand the public's understanding of the disease and give hope to those already impacted by Parkinson's.

Parkinson's disease treatment options


While every patient's treatment plan will differ, almost all will start with medications, as these tend to be most effective in the earlier stages of Parkinson’s disease.

The optimal medication plan varies from person to person, and your doctor can help you find the right medication--or combination of medicines—to give you the most relief with the fewest side effects. Over time, as the medications become less effective, doses can be increased and new medications may be added.

There are numerous medications that are used to treat Parkinson's, including: Expand All

  • Levodopa (L-DOPA)
    Chemical "precursor" that the brain will convert to dopamine. Used to replace the dopamine that is not being produced in the brains of Parkinson’s disease patients
  • Carbidopa
    Prevents the breakdown of Levodopa before it reaches the brain. Almost always given in conjunction with L-DOPA
    Parcopa® Sinimet® Rytary™ Duopa™ (carbidopa/levodopa)
  • Dopamine agonists
    Can be used in place of or in combination with levodopa
    Neupro® Mirapex® Requip® Parlodel® Dostinex® Apokyn® Permax™
  • Catechol-O-methyltransferase (COMT) inhibitors
    Increases the concentration of dopamine in the brain, giving more opportunity for the drug to work
    Comtan® Stalevo® Tasmar®
  • Anticholinergics
    To reduce tremor or rigidity1
    Akineton® Artane® Cogentin®


While exercise can't treat Parkinson's disease, it has been shown to slow the decline. In a 10,000 patient clinical trial, at least two and a half hours of physical activity each week—including strength, flexibility and aerobic exercise—has been shown to prolong better quality of life.5


Ablative surgery

Pallidotomy and thalamotomy are non-reversible surgeries that use targeted application of heat to destroy neural tissue driving Parkinson's symptoms.


Deep Brain Stimulation is a surgical procedure designed to help control motor symptoms while allowing for a reduction in medication. For DBS to be effective, the device must be implanted when motor symptoms are still responsive to levodopa; that is, before the Parkinson's drugs start to lose their effect.

The biggest thing for me about DBS is consistency. I know how I'm going to feel today, and tomorrow I can go on a hike and not worry that I won’t be able to come back down.

—Suzanne F., DBS Patient

Parkinson's disease progression

By the time people with Parkinson's disease typically begin to experience symptoms, the majority of their motor neurons have already been lost or impaired. Slowly, over time, symptoms worsen and become more difficult to control with medication. In addition, the Parkinson's medications can also start to produce unwanted side effects of their own, such as uncontrolled movements known as dyskinesia, as well as hallucinations. The progression of the disease varies considerably from person to person.

Signs that your medicine is becoming increasingly less effective include:

  • You have fewer hours a day with good control of your movement (less "ON time").
  • It takes longer for your medication to kick in after taking a dose.
  • Your medication seems to wear off earlier than it used to.
  • You have to take your medication more often.
  • You start to experience side effects like unintended movements (dyskinesia).

ON/OFF fluctuations with Levodopa treatment

  • Early PD
  • Moderate PD
  • Advanced PD
  • Initially, many patients achieve good motor control with L-DOPA therapy ("ON time"). As the dose wears off, the symptoms of Parkinson's return ("OFF time")

  • As the disease advances, patients will need to take additional doses at more frequent intervals to achieve control.

  • Very high doses of L-DOPA can cause unintended side effects such as dyskinesia, rapid, uncontrolled movements. ON/OFF fluctuations are often a catalyst for a switch to other medication.

"I refuse to give in to this disease. It doesn't get to win. My message to anybody considering DBS surgery would be: Why put up with the symptoms of this disease?"*

—Kenneth B., DBS Patient