Everything you want to know about your Parkinson’s medications

Parkinson Medication

Ever wonder why your doctor is prescribing a new medication for you? Or changing the timing or dosage of the one you are taking now? And what about side effects? What should you watch out for and report to your physician? Medications to Treat Parkinson’s Disease, a new professional resource from Parkinson Canada could provide these answers, and all in one convenient resource.

This guide for individuals and health professionals, written by Tejal Patel, BScPharm, PharmD, and Feng Chang, BScPharm, PharmD, will be available next month.  Canadians can access this resource in French and English, online at www.parkinson.ca and www.ParkinsonClinicalGuidelines.ca.  The booklet outlines how each medication works, its side effects and tips about adjusting medication, always under medical supervision.

The publication includes self-monitoring tools such as calendars and surveys that you can fill out and discuss at your medical appointments, ensuring that you are in control of your Parkinson’s at every step.

“This booklet empowers people living with Parkinson’s, as well as their care partners and health care providers, by giving each person the knowledge they need about Parkinson’s medications,” says Grace Ferrari, Senior Manager, Education and Support.

You will learn how to get the best performance from your medications. You will be more aware of tracking side effects, so that you can explain them accurately to your health care professionals and make the necessary medication adjustments. Health professionals will appreciate the convenience of a single resource, and families will benefit from the detailed information.

“Ultimately, we hope the book improves the quality of life for people living with Parkinson’s and their families,” says Ferrari.
The booklet will be distributed to health centres, doctor’s offices and pharmacies across the country, for both the professionals who work there, and the clients who visit. Medications to Treat Parkinson’s Disease will be officially launched at an educational event with one of the authors in Montreal on April 26, and it will be available before that date. Health care providers can contact education@parkinson.ca to access bulk quantities for their patients and clients.

Authors Patel and Chang are also working on a mobile phone application (app) to help individuals keep track of their medication regime, including timing reminders, symptom fluctuations and side effects. The app will also help health care professionals in selecting and adjusting medications for their patients with Parkinson’s. Parkinson Canada plans to launch this new app in June at the Canadian Pharmacists Conference in Quebec City.

Be sure to check in regularly at www.parkinson.ca for the latest Parkinson Canada education resources to help you live your best life with Parkinson’s. And visit our Knowledge Network for video and audio resources.

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A pharmaceutical workhorse leads the way

Dr. Jonathan Brotchie
Dr. Jonathan Brotchie

Among the world’s best-known and most successful drugs is chloroquine, which over the last 70 years has remained an effective treatment for malaria and rheumatoid arthritis.  Now, researchers are investigating chloroquine’s potential to slow the development of Parkinson’s disease.

Dr. Jonathan Brotchie has high hopes for chloroquine, which has demonstrated its ability to interact with one of the brain’s primary growth factors, a protein responsible for the health of the cells in this complex organ. This research is being funded with a $45,000 Porridge for Parkinson’s (Toronto) pilot project grant from Parkinson Canada’s Research Program.

Preliminary work with laboratory mice has shown that chloroquine could stave off the biochemical damage Parkinson’s inflicts on the brain, which should also mitigate effects such as worsening motor control, says Brotchie, a Senior Scientist at Toronto Western Hospital, part of the University Health Network.

Because chloroquine is widely available in a generic form, however, there is little incentive for any pharmaceutical company to assume the risk and expense of exploring the potential of a product that could as easily benefit its competitors.

That’s why Brotchie is grateful to Parkinson Canada for providing funding so he can conduct the preliminary research that could encourage one of these firms to adapt the drug to fight Parkinson’s.

“If I can demonstrate that chloroquine works, then that’s going to de-risk Parkinson’s disease,” he says.

Chloroquine might not be the only drug that can produce the same results in the brain, but it might be the only one available now, and it has already been shown to be safe, Brotchie says. More importantly, what Brotchie and his colleagues learn from working with chloroquine will lay the foundation for future research into even better medications.

“In the long term, chloroquine might not be the best growth factor stimulator, but right now we don’t have anything that has been proven to slow down the progression of the disease,” he says. “Rather than wait 15 years for something better to come along, I feel there’s an opportunity here now.”

It was an inspirational lecture at medical school that originally inspired Brotchie to take several years out of his medical studies to concentrate on brain research.  This research led to a career committed to working on Parkinson disease, to help patients however he could. Chloroquine, he believes, is well worth investigating.

“We want to do everything we can to be responsible for the development of the treatments of tomorrow,” he says.

Read about other researchers recently funded by the Parkinson Canada Research Program by visiting the research section of www.parkinson.ca.

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Join us this April in person and online: Live well and learn about PD

Volunteer Services Coordinator Elisabeth Schoep and her daughter Ella sell tulips for Parkinson Awareness Month.
Volunteer Services Coordinator Elisabeth Schoep and her daughter Ella sell tulips for Parkinson Awareness Month.

In celebration of Parkinson Awareness Month, Parkinson Canada is offering a variety of learning opportunities and unique fundraising and awareness activities online and in communities across the country. Many activities are planned for April, while others take place throughout the year. Mark your calendar and register now for the events you’d like to attend, as spaces may be limited. For a complete schedule of what’s happening in your community, visit the interactive map on our website for local event listings.

The following are just a sampling of the many events planned across the country. Take note that many require advance registration and spaces can fill up quickly.

World Parkinson’s Day – Celebrating 200 years. Join us online for a cross-Canada podcast with Sandie Jones, Information and Referral Associate, Parkinson Canada. April 11, noon to 1 p.m. EDT. Connect free of charge via phone or computer. For more details, visit our online Knowledge Network here.

Mind over Matter. Education and awareness conference. Sat, April 1, 8:30 a.m. to 4:30 p.m. The Westin Nova Scotian, 1181 Hollis St, Halifax, N.S. To register online, please click here. Early bird pricing is available for the first 100 people to register. For more information about the conference, please contact Ryan Underhill at ryan.underhill@parkinson.ca or call 1-800-663-2468.

Parkinson‘s Medication and You (Vous et la Médication pour le Parkinson’s). Bilingual symposium for the public. Wednesday, April 26, from 11:00 a.m. to 3:30 p.m., Gelber Conference Centre, 5151 Ch. de la Côte-Sainte-Catherine, Montréal, QC. Featuring keynote speaker Dr. Tejal Patel, BSc Pharm, Pharm D. Physiotherapist Paola Campana will also present on exercise and Parkinson’s. For more details and to register, click here.

Hope in Bloom. In centres large and small across Ontario, volunteers will be selling tulips, a traditional sign of spring and the international floral symbol of hope for people living with Parkinson’s. Pots of tulips and bouquets of cut stems will be sold for $10 each in public venues. And, for the first time, tulips will be sold in the Ottawa area on April 20th at Minto Place. Tulips are also being sold in Saskatchewan. For more details, visit the Saskatchewan online event calendar for April.

Comedy Night for Parkinson’s. Parkinson Canada proudly partners with Yuk Yuk’s for a laugh- out-loud fundraising event, April 8, beginning at 6:30 p.m. at Centrepointe Theatres, 101 Centrepointe Dr., Nepean, ON. Featuring: Don Kelly, Michelle Shaughnessy, and headliner Scott Faulconbridge. Pre-show social and silent auction starts at 6:30 p.m. in the Atrium. Comics hit the stage at 8:00 p.m. Click here to purchase $40 tickets.

Parkinson’s disease and depression, a public presentation and discussion. April 26, 6 p.m. to 8 p.m. at Toronto Botanical Gardens, 777 Lawrence Ave. E., Toronto, ON. Featuring special guest Mr. Andy Barrie, Dr. Mateusz Zurowski and social worker Janice Stober. Advance registration is required for this event. Contact Naseem Jamal at Naseem.jamal@parkinson.ca or call 416-227-3377.

Let’s Talk Parkinson’s. Conference in Winnipeg, MB. Saturday, April 8, 10:30 a.m. to 3:00 p.m. at Viscount Gort Hotel and Conference Centre, 1670 Portage Avenue, Winnipeg, MB. Featuring keynote speaker Dr. Douglas Hobson, along with fitness trainer Bonnie Hopps on Tai Chi and Gizmos & Gadgets, a question and answer panel session and Jeannine Carmen on Laughter Yoga. Early bird rate is available until March 17. Registration deadline is March 31. For more details and to register, click here.

What You Need to Know About Living with Parkinson’s. Forum in Brandon, MB. Saturday, April 29, 1:30 p.m. to 4:00 p.m., Royal Oak Inn & Suites/Clarion, 3130 Victoria Avenue, Brandon, MB. Featuring keynote speaker Dr. Douglas Hobson and Kelly Williams, RNBN GNC(c), both from the Movement Disorder Clinic at Deer Lodge Centre in Winnipeg. Tickets are $15 per person and the registration deadline is April 24. For more information and to register, click here.

Knocking out Parkinson’s: How to add boxing as an exercise.  Friday, April 28, 7 p.m. to 9 p.m. Hotel Ramada Plaza Regina, 1818 Victoria Avenue, Regina, SK. Tickets are $25 per person. Registration deadline is April 20. For more information and to register, contact michelle.carlson@parkinson.ca or call 306-933-4481.

Living Well Education Conference. Saturday, April 29, 9:30 a.m. to 3:00 p.m., Hotel Ramada Plaza Regina, 1818 Victoria Avenue, Regina, SK. Tickets are $65 per person and include lunch. Registration deadline is April 20. For more information and to register, contact michelle.carlson@parkinson.ca or call 306-933-4481.

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The value of basic research: Discovering links to Parkinson’s

Geoffrey Hesketh, Cell biologist
Geoffrey Hesketh, Cell biologist

The beauty of basic research is that sometimes, when you’re not looking for it, you make a discovery that answers a critical question in an entirely new or different field.

That’s what happened to Geoffrey Hesketh. Hesketh, a cell biologist, was investigating how proteins move around in cells to arrive at their surface in the correct order required to do their jobs.  He was concentrating on the Retromer proteins, a group of proteins that work together to pick transport proteins from their starting point to the correct spots that allow them to send and receive communications signals.

Other researchers had already figured out that damaged forms of one particular protein in the group – a protein called VPS35 – lead to Parkinson’s disease. Hesketh’s work revealed that nine other genes associated with Parkinson’s disease are also part of the Retromer group. That discovery points to this group of proteins as being critical players in the cause of Parkinson’s disease.

One theory is that any defect in the Retromer pathway results in fewer proteins getting to the right spots on the surface of brain cells. That could disrupt communication among the cells. Cells that produce dopamine – the chemical in the brain that affects movement – could be more susceptible to this disruption.

“Or it just could be that after losing their connections with the neighbouring cells, these cells (with damaged Retromer proteins) just shrivel up and die,” Hesketh says.
Knowing exactly what goes wrong at the cellular level is critical for the design of any future drug to treat Parkinson’s, says Hesketh.

Now Hesketh, who has switched the focus of his project to Parkinson’s, uses a technique called mass spectrometry to screen all the proteins in the Retromer group. He wants to identify all the proteins they communicate with, because they could also be implicated in Parkinson’s disease. (Genes make proteins to perform functions.)

Hesketh is now more than halfway through a two-year, $100,000 Basic Research Fellowship from the Parkinson Canada Research Program to pursue this research at the Lunenfeld-Tanenbaum Research Institute at Mt. Sinai Hospital in Toronto.

At this point, he’s most excited about the discovery of molecular insights into the “membrane targeting” or clumping of alpha-Synuclein (a-Syn), a gene at the very centre of Parkinson’s disease, and long suspected in the formation of Lewy bodies.

“Knowledge of the precise mechanism of a-Syn membrane binding would be of significant value to the Parkinson’s research community and has the potential to lead to new treatments,” says Hesketh.

Another aim of his work is to complete a “BioID,” and mass spectrometry, of all of the genes known to be associated with Parkinson’s disease, about 50 in total – so far. He is collaborating with Drs. Ted Fon and Heidi McBride of the Montreal Neurological Institute at McGill University, who also have relationships with Parkinson Canada. (Dr. Fon is a previous Chair of our Scientific Advisory Board.)  He is also investigating with them on how the various genes and their proteins impact the quality of a cell’s mitochondria, its energy source.

Hesketh is passionate about the need for basic research and its unintended consequences. “Parkinson’s found me, rather than the other way around,” he says. “I was looking into a pathway that I was pursuing out of curiosity. After a couple of years, we stumbled upon this connection to Parkinson’s disease that probably never would have been found, if we hadn’t gone down this curiosity-driven path. The discovery provided a new framework to my research.”

He’s a good example of how basic science research expands our knowledge base and can lead to potential new avenues of exploration and possible clinical applications.

“My research aims to characterize the interactions made by Parkinson’s-associated genes with the goal of identifying cell pathways and functions central to the development and progression of Parkinson’s disease. This investigation offers great promise in discovering the fundamental cause of Parkinson’s, and I believe, offers our best shot at ultimately finding a cure.”

You can watch our previously recorded interview with Hesketh.  You can also read about other researchers funded by the Parkinson Canada Research Program on our website at www.parkinson.ca.

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Preventing brain cells from running out of fuel

Dr. Wei Yi
Dr. Wei Yi

Most of our body’s cells contain mitochondria, small components crucial to ensuring that a cell obtains adenosine triphosphate (ATP), a molecule that provides essential chemical energy for biological functions. When mitochondria are damaged, a cell must remove them before they contaminate it, which can lead to cell death.

“It’s really important to get rid of these mitochondria so that the cell can continue to make use of ATP,” says Wei Yi, a post-doctoral fellow at McGill University’s Montreal Neurological Institute. “It’s a question of making the most of this vital resource.”

Wei Yi was recently awarded a two-year, $80,000, Basic Research Fellowship from Parkinson Canada Research Program. Yi’s research focuses on how damaged mitochondria are handled by neurons carrying dopamine, the complex agent that codes signals for movement control in the brain.

She developed an interest in neurodegenerative diseases like Parkinson’s while studying for her PhD at the Chinese Academy of Sciences.  “I am also interested in the aging population of China, where larger numbers of people are likely to be affected by these diseases.”

Like other cells, neurons regularly remove all kinds of waste material, including mitochondria. This process, known as autophagy, is a rapidly expanding frontier in many areas of medicine. In the case of damaged mitochondria, an enzyme called PINK1 identifies and isolates these components in preparation for disposal. However, in as many as half of patients suffering from early onset Parkinson disease, PINK1 is itself damaged. It can no longer direct the removal of mitochondria.

“When this happens PINK1 is not actually protecting the cells,” Yi says. “They can end up with bad mitochondria and they will die from a lack of energy.”

As part of learning more about this problem, her research has revealed another enzyme, called MPP, which appears to control PINK1.

“By understanding this mechanism, we can find the pathways that could activate them again,” she explains. “If we can determine the relationship between PINK1 and MPP, it will provide a new way of treating Parkinson disease.”

Read about other researchers recently funded by the Parkinson Canada Research Program by visiting the research section of www.parkinson.ca.

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