Symptom management and supporting quality of life
Parkinson’s disease is a progressive neurological condition that currently has no cure. Treatment includes a team of specialists caring for patients using a combination of medicines and allied health support.
A range of effective treatments is available to help manage symptoms and support quality of life when living with Parkinson’s disease. In some cases, device-aided or ‘smart' therapies are considered for selected patients with specific symptom patterns. This is a specialist decision.
Treatment is tailored to each person and reviewed regularly as needs change over time.
Types of treatments
Parkinson's disease is best managed by a coordinated team rather than a single doctor. This typically includes:
- a neurologist or movement disorder specialist, who manages Parkinson's-specific treatment
- allied health professionals, including physiotherapists, speech pathologists, occupational therapists, counsellors and dietitians
- nurses including Parkinson's nurse specialists where available
- your GP who oversees your general health and coordinates care.
The balance of your team will shift over time. Allied health support often becomes more central as the disease progresses, while specialist input increases if more advanced therapies are being considered.
Most Parkinson's medicines work by increasing dopamine activity in the brain. Broad categories include:
- levodopa-carbidopa – generally the most effective medicine for movement symptoms and the mainstay of treatment for most people
- amantadine – used for mild symptoms and at higher doses to help reduce involuntary movements that can develop with long-term levodopa use.
- COMT inhibitors – improve the absorption of levodopa from the gut and are used as an add-on when patients have developed wearing off
- dopamine agonists – stimulate dopamine receptors directly. This can be effective but require monitoring for specific side effects, such as impulsive behaviours (eg gambling or compulsive spending)
- MAO-B inhibitors – provide a modest boost to dopamine activity, often used in earlier disease or as an add-on.
The choice of medicine, timing and dose are individualised and adjusted over time as symptoms and the disease stage change. All Parkinson's medicines can cause side effects and your specialist will discuss potential effects to watch for at your appointments.
For some people with more advanced Parkinson's whose symptoms are no longer well controlled by tablets alone, additional options may be considered, including:
- continuous infusion therapies – medicine delivered continuously via:
- a small pump
- delivered into the small intestine (eg levodopa-carbidopa gel)
- under the skin (eg apomorphine or foslevodopa)
- deep brain stimulation – a surgically implanted device that delivers electrical stimulation to specific brain areas
- focused ultrasound – an incisionless procedure suitable for selected patients who are troubled predominantly by unilateral tremor.
These therapies can meaningfully improve movement symptoms in well-selected patients, but they do not stop disease progression and do not reliably improve non-movement symptoms such as memory or balance.
Some of these specialised therapies are most effective when used in early Parkinson’s disease, when the therapeutic window matters most. Your specialist will identify which therapies best suit you, your symptoms and lifestyle.
Non-medicine support is a core part of Parkinson’s care, and not an optional extra. A range of therapies and lifestyle measures can help, including:
- bone health, to screen and if necessary, treat osteoporosis given the risk of falls
- dietary support to help with weight, constipation and medicine timing
- occupational therapy to support home safety and daily activities
- physiotherapy to support walking, balance and fall prevention
- regular exercise, which has growing evidence for benefits on movement symptoms, mood and overall function (recommended alongside, not instead of, medical treatment)
- speech pathology to support voice and swallowing.
When to seek specialist review
It is recommended that you request a review with your treating team if you experience:
- difficulty swallowing
- falls and freezing when walking
- new involuntary movements
- new or worsening confusion, hallucinations or unusual behaviour changes
- symptoms wearing off between medicine doses.
Common patient questions
No, there is currently no cure but clinical trials are ongoing. Treatment focuses on managing symptoms and maintaining function and quality of life.
No, currently available medicine has been proven to reliably slow the underlying progression of Parkinson's disease, and are mainly used to help manage symptoms.
Many patients are managed well with medicines and allied health support alone.
In some cases, device-aided therapies are considered for patients with specific symptom patterns and this is always a specialist decision.
Regular exercise, allied health input and good general health management (sleep, nutrition and social connection) all play a meaningful role alongside medical treatment.