Treatments for Parkinson’s disease aim to manage symptoms and improve quality of life. However, it’s important to be aware that a medication or procedure can have its own set of side effects or lead to other complications. By working closely with your health care provider, you can weigh a therapy’s health benefits and unwanted effects to find the best treatment plan for you or your loved one with Parkinson’s.

Dopaminergic Medications and Their Side Effects

The most commonly prescribed drugs used to treat Parkinson’s disease are dopaminergic medications. These drugs work by influencing levels of the neurotransmitter (brain chemical) dopamine. Parkinson’s disease symptoms are caused by low levels of dopamine in the brain.

Dopaminergic medications include:

• Levodopa/carbidopa (Crexont, Duopa, Rytary, Sinemet)
• Levodopa (Inbrija)
• Levodopa/carbidopa/entacapone (Stalevo)
• Catechol-O-methyltransferase (COMT) inhibitors such as entacapone (Comtan), opicapone (Ongentys), and tolcapone (Tasmar; rarely used because it can harm the liver)
• Dopamine agonists such as apomorphine (Apokyn), pramipexole dihydrochloride, rotigotine (Neupro), and ropinirole
• Monoamine oxidase inhibitors such as rasagiline (Azilect), safinamide (Xadago), and selegiline (Eldepryl, Zelapar)

Common Side Effects of Dopaminergic Medications

As with any medication, dopaminergic medications come with side effects. Common side effects include:

• Constipation
• Nausea
• Vomiting
• Loss of appetite
• Dry mouth
• Headaches
• Confusion or forgetfulness
• Fatigue
• Sleepiness
• Difficulty falling or staying asleep
• Low blood pressure
• Blurred vision
• Decreased short-term memory
• Lightheadedness
• Nightmares
• Dyskinesia (involuntary swaying, twisting, jerking, or writhing)

Although levodopa is an effective drug for treating Parkinson’s disease, long-term use can cause dyskinesia. Amantadine drugs (Gocovri, Osmolex ER) can be combined with levodopa/carbidopa to treat dyskinesia while still managing Parkinson’s disease.

Rare and Serious Side Effects of Dopaminergic Medications

In rare cases, the side effects of dopaminergic medications can become serious. Seek help immediately if you’re taking this type of drug and notice any of these side effects:

• Depression
• Anxiety
• High fever
• Swelling of the hands, lower legs, ankles, and feet
• Shortness of breath
• Heart palpitations (fast, irregular heartbeat)
• Stomach pain
• Muscle stiffness
• Hives
• Chest pain
• Bloody vomit
• Abnormal stools (bloody, or black and tarry)
• Psychosis
• Risk-taking behavior
• Suicidal thoughts

Note: If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.

Psychosis is a serious mental condition. It can present as hallucinations (hearing or seeing things that don’t exist), paranoia (not trusting others or thinking others want to hurt you), and delusions (believing false information).

Dopamine agonists can sometimes lead to impulse control problems, causing risky behaviors such as gambling. These agents may also cause orthostasis (low blood pressure when you stand up) and sleep attacks, which can be dangerous, especially while driving.

It’s important not to stop taking dopaminergic medications suddenly unless your doctor advises it. Stopping abruptly can lead to a life-threatening emergency that includes psychosis, high fever, and severe muscle stiffness.

Symptom Management Medications and Their Side Effects

Other medications can be used to help manage the symptoms of Parkinson’s disease or side effects of its treatments. These medications commonly include droxidopa (Northera) for low blood pressure or dizziness when standing up. The antipsychotics pimavanserin (Nuplazid) and quetiapine (Seroquel) are also prescribed for psychotic symptoms such as paranoia and hallucinations. A medication called rivastigmine (Exelon) also may be prescribed to treat dementia in people with Parkinson’s disease.

Common Side Effects of Symptom Management Medications

Medications that help manage Parkinson’s symptoms or treatment side effects should improve your overall quality of life. However, these drugs can also come with some side effects, including:

• Headache
• Irritability
• Unusual dreams
• Nausea
• Vomiting
• Constipation
• Indigestion
• Dizziness
• Dry mouth
• Swelling of the feet, ankles, or hands
• Increased appetite, which can lead to excessive weight gain

Rare and Serious Side Effects of Symptom Management Medications

Rarely, serious side effects can develop after taking medication to help manage Parkinson’s disease or treatment side effects. Get medical help right away if you begin to experience any of these symptoms:

• High fever
• Confusion
• Hallucinations
• Muscle stiffness
• Difficulty walking
• Uncontrollable muscle movements
• Changes in mental state
• Hives or a rash
• Shortness of breath
• Swollen tongue
• Tightness in the neck and throat
• Seizures
• Excessive sweating

Deep Brain Stimulation

Deep brain stimulation (DBS) involves electrode implants that stimulate certain regions of the brain. This type of electrical stimulation can help treat movement disorders such as Parkinson’s disease. If you undergo surgery for DBS, your surgeon will drill small holes in your skull to place the electrodes in your brain. They’ll also place a device similar to a pacemaker in your upper chest to help control the electric signals.

There can be side effects from both the surgery for DBS and the treatment itself.

Common Side Effects of Deep Brain Stimulation

Electrical impulses sent through the electrodes to the brain can cause side effects such as:

• Lightheadedness
• Problems with vision
• Difficulties with speech
• Numbness or tingling
• Muscle tightness in arms or face
• Balance problems
• Changes in mood, such as depression or anger

Rare and Serious Side Effects of Deep Brain Stimulation

Surgery is an intensive process that can lead to rare yet serious complications. Your neurologist and surgeon should discuss the procedure’s risks and benefits with you before surgery. Complications from surgery include:

• Infection
• Seizures
• Bleeding in the brain
• Stroke
• Breathing problems
• Misplacement of electrodes in the brain tissue

If You Have Side Effects From Your Treatment

Before you begin treatment, your neurologist should discuss which options are best for you, considering all possible side effects. Generally, the benefits of a medication or procedure outweigh the side effects. If you find that side effects are too much to handle, talk to your doctor about other options.

Talk With Others Who Understand

MyParkinsonsTeam is the social network for people with Parkinson’s disease and their loved ones. On MyParkinsonsTeam, more than 105,000 members come together to ask questions, give advice, and share their stories with others who understand life with Parkinson’s disease.

Do you have any side effects with your Parkinson’s treatment? Share your experience in the comments below, or start a conversation by posting on your Activities page.