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Everything You Need to Know About Suspension Therapies for Parkinson’s Disease

Medically reviewed by Ricky Chen, MD on February 15, 2017Written by Rena Goldman on February 15, 2017
suspension therapy

You may have heard the term “suspension therapy” mentioned as a treatment option for Parkinson’s. The word “suspension” refers to the way medication is delivered to your body. Instead of being swallowed as a pill, the medicine is given in gel form directly into your small intestine.

This treatment is relatively new for Parkinson’s, but it’s considered to be effective. Read on to learn about suspension therapy and when to talk to your doctor about it.

What suspension therapy is

Currently, only one type of medication is approved by the Food and Drug Administration for suspension therapy in Parkinson’s. It’s called Duopa and is made using the same drug combination — levodopa and carbidopa — already considered to be effective in treating Parkinson’s symptoms.

Levodopa and carbidopa are usually taken as a pill. Not producing enough dopamine is what causes Parkinson’s symptoms, but you can’t take dopamine directly. When levodopa, a chemical that’s found naturally in your brain, passes through your brain, it’s turned into dopamine. Carbidopa is added to make sure your body doesn’t break down levodopa too quickly and to help prevent side effects, like nausea and vomiting.

How suspension therapy works

As Parkinson’s progresses, medication becomes less effective at relieving symptoms. You may start to experience “off times” when your medicine has worn off. Problems with the way your digestive system works is a part of the disease, so your body may not absorb medication as well when it’s taken by mouth.

Suspension therapy offers an alternative to pills that research shows is effective. Instead of being in pill form, the active parts of these medications are suspended in a gel.

Using a minor surgical procedure, a tube is placed inside your body to bypass your stomach and go directly to your small intestines. The tube is then connected to a pouch outside your body that holds the gel medication. The pouch is small enough to hide under your shirt. Each one of the small containers holding medicine, called cassettes, have enough gel to last for 16 hours.

The medication is distributed through a suspension pump. This pump has to be digitally programmed by a trained professional to release medication in the correct amounts. But you will have to put in the cassettes. Your doctor will tell you how often you need to change the cassette.

Studies have shown that this type of delivery helps to increase the length of time symptoms are treated because the medication remains in your system. It also decreases the negative symptom of involuntary movements (dyskinesia) that are associated with higher doses of levodopa needed in later stages of Parkinson’s.

Possible complications

Even though suspension therapy is considered effective, it’s not for everyone. The tube needs to be carefully monitored to make sure there is no infection or clog that can prevent your medicine from being delivered correctly.

If you aren’t able to do this on your own, it’s likely not safe to use the suspension pump unless you have a caregiver to help monitor it.

Talking to your doctor

Everyone’s experience with Parkinson’s is different. For some people, the disease takes longer to progress, and not all of the same symptoms happen to everyone. That’s why it’s important to tell your doctor how you’re feeling and how your current treatment has been working.

Suspension therapy isn’t started at the beginning stages of the disease. Instead, it’s often considered after Parkinson’s starts to progress. When you start noticing that your medication isn’t working as well for as long as it used to, that’s a good time to talk to your doctor about other types of treatments.

Ask your doctor if they feel suspension therapy is a good option for you at this stage of the disease.

Since Duopa was approved in 2015, there aren’t yet other suspension therapies for Parkinson’s on the market. But as research continues, there may soon be other options.

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