Medication Update – Apomorphine (Movapo)

We are pleased to inform you that apomorphine (MOVAPO) has received a positive recommendation by CADTH, the Canadian Agency for Drugs and Technologies in Health. Parkinson Canada filed a patient evidence submission for the review process that was informed by a survey from nearly 900 people with Parkinson’s and caregivers, as well as interviews with individuals using apormorphine in Europe. Here’s the full recommendation report from CADTH:

A positive recommendation means CADTH is recommending that the provinces offer public coverage for the cost of the drug for patients (with conditions):


Indication: Parkinson’s disease


The CADTH Canadian Drug Expert Committee (CDEC) recommends that apomorphine hydrochloride (apomorphine) be reimbursed for the acute, intermittent treatment of hypomobility “off” episodes (“end-of-dose wearing off” and unpredictable “on/off” episodes) in patients with advanced Parkinson’s disease (PD), if the following criterion and conditions are met:


  • Apomorphine should only be used as adjunctive therapy in patients who are receiving optimized PD therapy (levodopa and derivatives and dopaminergic agonists) and still experiencing “off” episodes.


  • Patients treated with apomorphine should be under the care of a physician with experience in the diagnosis and management of PD.
  • Reduction in price.

This is a positive and necessary step to getting equitable access to the drug for people with Parkinson’s who would benefit from it; however, this is the beginning of the process.

Please don’t make any changes to your therapeutic regimen without discussing this first with a health professional. Remember that your doctor or pharmacist can help you manage your medications.

Parkinson Canada will continue to monitor the availability of apomorphine and will share updates as they become available. If you have any questions about this process or other matters concerning the Parkinson’s community, contact Parkinson Canada’s advocacy team at (800) 565-3000, ext. 3501 or email

Tanya Good joins Parkinson Canada in Alberta

Tanya Good Image
Manager, Parkinson Canada, Alberta Office

Parkinson Canada is pleased to announce that Tanya Good has joined the national health charity as Manager, Alberta. She leads all aspects of Parkinson Canada’s Alberta operations, including program and service delivery, local events and community fundraising.

Tanya will play a key role in expanding Parkinson Canada’s services to Albertans.  Opening an office in Calgary and growing relationships with communities, this builds on the services delivered by Parkinson Canada to Albertans for more than 50 years.

“Reaching out to organizations and individuals across the province, I look forward to improving the lives of Albertans living with Parkinson’s,” says Tanya Good.

Tanya is a capable, experienced leader with more than 24 years of experience in the non-profit sector developing programs. She is committed to improving the lives of people living with Parkinson’s and has worked  with  people living with Parkinson’s since 2011 in Alberta.  Her strengths are in building community support, developing coalitions and forging strong relationships. She has demonstrated this throughout a solid career in various community-based organizations.

To connect with Tanya Good and Parkinson Canada in Alberta, call 1 (800) 565-3000, ext. 3461, (local 587-712-9393), email or in person, visit our community office located in The Village at 230C – 4039 Brentwood Road NW, Calgary.

About Parkinson Canada

Parkinson Canada provides services, support and education to individuals and the health care professionals that treat them. Operating since 1965, the organization advocates on issues that concern the Parkinson’s community in Canada. We fund innovative research for better treatments and a cure. The organization works with coalitions and community partners on a broad range of initiatives, to improve quality of life for the more than 100,000 Canadians who have Parkinson’s disease. Parkinson Canada is an Imagine Canada accredited organization and fulfills its mission through the generosity of donors. Visit

Easing the pain of Parkinson’s

Dr. Susan Fox

Pain is a constant companion for as many as 10 percent of people with Parkinson’s disease. Unfortunately, most of them can’t tolerate the sleepiness and confusion regular pain medications induce.

That’s why Dr. Susan Fox, a Toronto neurologist and professor at the University of Toronto, is investigating a different source of pain relief. Fox is conducting a pilot study, along with her colleague Dr Tiago Mestre in Ottawa, to see whether 15 people with Parkinson’s disease will benefit from oils made from cannabinoids – the active compounds in marijuana.

Currently, people with Parkinson’s may experience pain in their muscles and joints because of the stiffness and rigidity the illness causes. Some also report a sharp pain, often in their legs or feet, that is more puzzling because doctors can’t determine its exact cause.

“Some people call it central pain,” says Fox. “It’s probably mediated by some brain mechanism reflective of Parkinson’s. People express this as an unpleasant burning, stabbing pain, and it’s very difficult to treat.”

Fox, who treats people with Parkinson’s at Toronto Western Hospital’s Movement Disorders Clinic, hopes her study will discover whether people with Parkinson’s can tolerate oils, and experience less pain after using them. She also wants to identify the best strength and dosage for people to use.

Almost every day, one of her patients asks her about trying marijuana to relieve their tremors or rigidity.

But although marijuana might help people relax and feel less rigid temporarily, there’s no evidence that it relieves those symptoms long-term, she says.

“There’s always this misconception that cannabis can help anything and everything,” she adds.

Fox would rather see her patients try approved and safe medications to relieve tremors and rigidity, so that’s why this study is focused on determining if there is any benefit of  cannabis oils to treat pain.

Fox’s study will also assess whether these oils cause drowsiness and lower blood pressure – already a concern for people with Parkinson’s. There is also a small risk the oil could induce or worsen hallucinations – a symptom some people are already experiencing.

If Fox’s research demonstrates that people can tolerate cannabis oil and it doesn’t have worrisome side-effects, then her results could lead to a larger, randomized controlled trial.

“There are clear risks and side effects with cannabis, so you weigh up the risk versus the benefit ratio,” she says.

Most importantly, Fox hopes the cannabis oil will not only help people with Parkinson’s feel better, it will also relieve a burden for their caregivers.

“It’s an unmet need,” she says. “It’s very challenging for the family, as well, to watch their loved one in pain and agony.”

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

Improving damage detection in the brain

Professor Jean-François Trempe

A pair of proteins, whose malfunction is associated with Parkinson’s disease, normally work together to fulfill valuable housekeeping chores within the body. They keep brain cells healthy, for example, by discarding dead or dying material inside them. But these proteins have to be tightly controlled, because if they “help” too much, they can become harmful. When they aren’t regulated, the damaged proteins end up killing the brain cells they were designed to save.

“It’s like having a bulldog on a leash,” says Jean-François Trempe, an assistant professor at McGill University’s Department of Pharmacology and Therapeutics. “You have to keep it under control.”

A decade ago, Trempe began studying Parkin, one of the most powerful of these proteins.

“Parkin is a protein that can destroy parts of the cell, so you don’t want it to be active all of the time,” Trempe says.  “You only want it to get rid of the bad parts of cells.”

Parkin’s activity is controlled by another protein, a gene called PINK1. PINK1 constantly enters the  mitochondrion, an internal part of the cell that oversees the production of energy. When the mitochondrion is healthy, it simply eliminates PINK1. If it is malfunctioning, however, PINK1 builds up within brain cells, which serves as a signal to Parkin to move in and eliminate them.

The disruption of mitochondrial function is a hallmark of Parkinson’s disease, which has led Trempe to regard PINK1 as a key to understanding this process. Other cells in the body are also susceptible to mitochondrial damage, he says, but they manage to recover successfully. Those brain cells that do not recover appear to be under stress, and thus are more sensitive to the loss of PINK1.

“This is what I find fascinating — why a mutation in a gene that you find everywhere only causes the loss of a subset of neurons,” he says. “This is what we think is happening.”

There are very few genes like PINK1 in the body, which makes it all the more interesting to study. If specific compounds can be identified to stabilize PINK1 so bad mitochondria are more readily detected and removed by Parkin, the result could allow these cells to repair themselves, fending off the onset of Parkinson’s disease.

“We need to confirm this idea (of cell reparation), which is why we are conducting this proof-of-concept study,” says Trempe. “It will be a tool that should lead us to some very effective strategies.”

Dr. Trempe’s 2 year Pilot Project Grant is funded by Peter Cipriano through the Parkinson Canada Research Program.

Read about other researchers recently funded by visiting the research section of