New Parkinson's Diagnosis? Here Are Steps You Can Take Now

Parkinson's disease (PD) is a neurodegenerative disorder caused by the loss of brain cells that produce dopamine , a brain chemical that helps coordinate movement, causing a variety of motor (movement- or motion-related) and nonmotor symptoms. Considered a progressive movement disorder, PD gets worse over time, but treatment can improve functioning and quality of life.

What Does Parkinson's Mean for Me?

Parkinson's disease manifests differently in each person, but it causes four primary symptoms that can significantly impact your daily activities and quality of life:

• Tremors (involuntary shaking), which usually start in the hands but may also affect the arms, legs, jaw, or head
• Muscle stiffness or rigidity (the muscles remain tense and contracted), which can be painful and limit range of motion
• Slowness of movement, known as bradykinesia, which can make even the simplest tasks take much longer to complete
• Impaired balance and coordination (postural instability), which can increase the risk of falls and typically appears later in the disease progression

With these symptoms, it's not uncommon for people with PD to develop what's known as the parkinsonian gait. This walking pattern is marked by a stooped or hunched posture; small, quick steps; and reduced swinging of one or both arms. When walking, a person with PD may also stop suddenly or freeze and have trouble initiating movement.

Other motor and nonmotor symptoms of PD include:

• Emotional and mood changes, including depression and anxiety
• Speech changes, such as speaking too softly and slurring speech
• Small, crowded handwriting
• Sleep problems
• Urinary and bowel problems, including incontinence and constipation
• Cognition and thinking changes, including dementia and hallucinations
• Muscle cramps
• Muscle and joint pain
• Sexual dysfunction
• Loss of smell

• Facial masking (reduced facial expression and blinking)
• Dizziness or even fainting when standing up ( orthostatic hypotension )
• Fatigue
• Oily or very dry skin
• Breathing and respiratory problems

• Vision changes such as double vision
• Swallowing issues
• Excessive sweating

What Can I Do for My Parkinson's?

Medication is a key component in managing Parkinson's. Here is a brief overview of commonly prescribed medications to manage the motor symptoms of PD.

Medication Purpose

levodopa-carbidopa ( Sinemet , Rytary , Parcopa , Dhivy , Duopa )

Replaces dopamine, improves motor symptoms

Dopamine agonists: apomorphine (Apokyn) , pramipexole (Mirapex) , rotigotine (Neupro) , ropinirole (Requip)

Mimic dopamine's effects

MAO-B inhibitors: rasagiline (Azilect) , safinamide (Xadago) , selegiline (Carbex, Eldepryl)

Prevent breakdown of brain dopamine

COMT inhibitors: entacapone (Comtan) , opicapone (Ongentys) , tolcapone (Tasmar)

Extend the effect of levodopa

Anticholinergics: benztropine (Cogentin) , trihexyphenidyl (Artane)

Block the brain chemical acetylcholine, reducing tremors and muscle rigidity

amantadine ( Osmolex , Gocovri , Symmetrel )

Provides short-term relief of dyskinesia (involuntary, uncontrolled movements)

Adenosine receptor antagonist: istradefylline (Nourianz)

Boosts dopamine signaling by blocking adenosine
There are also many medications available to treat specific nonmotor symptoms of PD. Some of these include:

Medication Symptoms Treated

rivastigmine (Exelon) , donepezil (Aricept) , memantine (Namenda)

Dementia

psyllium (Metamucil) , polyethylene glycol (Colace) , polyethylene glycol (Miralax) , bisacodyl (Dulcolax) , lubiprostone (Amitiza)

Constipation

paroxetine (Paxil) , venlafaxine XR (Effexor XR)

Depression

lorazepam (Ativan) , alprazolam (Xanax)

Anxiety

glycopyrrolate (Robinul) , Botox

Drooling

methylphenidate (Ritalin) , modafinil (Provigil)

Fatigue

droxidopa (Northera)

Low blood pressure

pimavanserin (Nuplazid)

Psychosis, hallucinations

sildenafil (Viagra) , tadalafil (Cialis) , vardenafil (Levitra)

Erectile dysfunction

oxybutynin (Ditropan) , tolterodine (Detrol) , mirabegron (Myrbetriq)

Urinary problems

eszopiclone (Lunesta) , zolpidem (Ambien) , zaleplon (Sonata)

Insomnia

modafinil (Provigil) , armodafinil (Nuvigil)

Excessive daytime sleepiness

Lifestyle Changes You Can Make Right Away

• Exercise regularly, making sure to include aerobic activity, strength training, gait and balance training, and flexibility exercises such as yoga.

• Eat a balanced diet rich in plant-based, high-fiber whole foods, including fruits and vegetables of all colors, whole grains, beans, and legumes.
• Avoid eating high-protein meals, as protein may interfere with levodopa absorption (instead, spread protein intake throughout the day).

• Stay hydrated .
• Get adequate rest by keeping a regular sleep schedule, maintaining a comfortable sleep environment, and reducing stimulating activities before bed (such as reading or using electronic devices).

• Practice stress management using techniques such as yoga, meditation, and deep breathing exercises.

What to Ask Your Doctor

When you visit your doctor, consider asking the following questions to better understand your situation and prepare for the future.

• What stage is my Parkinson's disease, and what can I expect in the future?
• What are my treatment options, and what do you recommend?
• How will these treatments help me, and what are the potential side effects?
• Are there any lifestyle changes I should make to manage my symptoms better?
• What resources are available for support and education?
• Are there clinical trials I can take part in?
• How often should I make appointments?
• What other specialists or healthcare professionals should be on my care team?
• What symptoms or side effects should I report immediately?

When Do You Need Urgent Medical Attention?

With Parkinson's disease, it's crucial to seek urgent medical attention if you experience any of the following.

• Severe or sudden worsening of symptoms, including severe tremor and unmanageable freezing
• Unexplained falls or injuries, as well as falls or injuries caused by orthostatic hypotension (lightheadedness after standing up)
• Severe depression or hallucinations
• Development of impulsive behaviors such as pathological gambling, compulsive shopping, and binge eating
• Difficulty swallowing or breathing
• Excessive daytime sleepiness and "sleep attacks" (abrupt, unplanned sleep during daily activities such as eating or driving)
• Abnormal sleep-related behaviors, particularly acting out unpleasant dreams during sleep (punching, jumping out of bed, or shouting)
• Dyskinesias (involuntary movements) that interfere with sitting, walking, and other daily activities

Your Parkinson's Care Team

Managing Parkinson's often requires a multidisciplinary approach. Your care team may include:

• Primary care physician
• Movement disorder specialist
• Neurologist
• Neurosurgeon
• Physical therapist
• Occupational therapist
• Speech therapist
• Urologist, gastroenterologist, and other specialists
• Dietitian
• Social worker, psychiatrist, or other mental health professional
• Pharmacist
• Nurse

Finding Support

Parkinson's Foundation

This nonprofit organization offers a wealth of helpful information about the disease, as well as useful resources and other support , including podcasts about treatments and techniques to improve quality of life and a helpline to answer PD questions and offer expert referrals.

Michael J. Fox Foundation

Dedicated to finding a cure for Parkinson's disease, this organization provides a variety of resources for support, including webinars and podcasts, real stories from PD patients, and a " buddy network " to help PD patients connect with other people living with the disease.

American Parkinson's Disease Association

The APDA seeks to help the Parkinson's community achieve better quality of life by providing referrals and information, education and support programs, health and wellness activities, a card game to improve intimacy with partners, and more. There are local ADPA Chapters and Informational & Referral Centers throughout the country, and the ADPA website has a tool to find local support groups, exercise classes, and other resources.

The Takeaway

Parkinson's disease can feel overwhelming, but you have options for managing it and improving your quality of life. Embrace regular exercise, a balanced diet, and medication to help with symptom management, and connect with a strong support system for emotional and social aid. Reach out to your healthcare team and local resources to guide you through your journey.

Resources We Trust

• Cleveland Clinic: Parkinson's Disease Medications
• Johns Hopkins Medicine: Newly Diagnosed With Parkinson's Disease: 7 Things to Do Now
• Parkinson's Foundation: New to Parkinson's
• Michael J. Fox Foundation: Resources for People Newly Diagnosed With Parkinson's
• Davis Phinney Foundation: A Primer on Parkinson's for the Newly Diagnosed

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

1. Parkinson's Disease. National Institute of Neurological Disorders and Stroke .
2. 10 Early Signs. Parkinson's Foundation .
3. Non-Movement Symptoms. Parkinson's Foundation .
4. Common Symptoms of Parkinson's Disease. American Parkinson Disease Association .
5. Medications for Motor Symptoms. Michael J. Fox Foundation .
6. Medications for Non-Motor Symptoms. Michael J. Fox Foundation .
7. Exercise. Parkinson's Foundation .
8. Uptmor A. Lifestyle Changes for Parkinson's Disease. University of Minnesota .
9. Sleep Disorders. Parkinson's Foundation .
10. Stress Management for PD. Parkinson's Foundation .
11. Simonet C et al. Emergencies and critical issues in Parkinson's disease. Practical Neurology . February 1, 2020.

Resources

• Parkinson's 101. The Michael J. Fox Foundation .
• Key Questions for Your Doctor's Visit. Parkinson's Foundation .

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Jason Paul Chua, MD, PhD

Medical Reviewer

Jason Chua, MD, PhD, is an assistant professor in the Department of Neurology and Division of Movement Disorders at Johns Hopkins School of Medicine . He received his training at the University of Michigan, where he obtained medical and graduate degrees, then completed a residency in neurology and a combined clinical/research fellowship in movement disorders and neurodegeneration.
Dr. Chua's primary research interests are in neurodegenerative disease, with a special focus on the cellular housekeeping pathway of autophagy and its impact on disease development in diseases such as Parkinson disease. His work has been supported by multiple research training and career development grants from the National Institute of Neurological Disorders and Stroke and the American Academy of Neurology. He is the primary or coauthor of 14 peer-reviewed scientific publications and two peer-reviewed online learning modules from the American Academy of Neurology. He is also a contributing author to The Little Black Book of Neurology by Osama Zaldat, MD and Alan Lerner, MD, and has peer reviewed for the scientific journals Autophagy, eLife, and Neurobiology of Disease. See full bio

Joseph Bennington-Castro

Author

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In addition to writing for Everyday Health, Bennington-Castro has also written for publications such as Scientific American , National Geographic online, USA Today , Materials Research Society, Wired UK , Men's Journal , Live Science, Space.com, NBC News Mach, NOAA Fisheries, io9.com, and Discover.

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