An Old Drug with New Tricks

Rivastigmine may improve Parkinson’s disease symptoms

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) Parkinson’s disease has long been in the public eye, partly due to efforts by affected celebrities like Michael J. Fox. But a cure remains elusive. However, an unexpected treatment may improve some of the disease’s most debilitating symptoms.

Rivastigmine (brand name Exelon), a drug commonly used to treat dementia associated with Parkinson's disease, may also prevent devastating falls among Parkinson’s patients, a new study found.

This new finding is likely a welcome one, considering that 7 million people worldwide have Parkinson’s, and 70 percent of those people fall at least once a year, according to a press release from Parkinson's UK. Those falls are often devastating, with one-third resulting in multiple falls, broken bones and hospital visits.

Parkinson's disease is a chronic central nervous system disorder that affects movement. Symptoms include tremors, stiff muscles, confusion and poor balance.

"With the degeneration of dopamine-producing nerve cells, people with Parkinson's often have issues with unsteadiness when walking," said lead study author Dr. Emily J. Henderson, a Parkinson's UK research fellow, in a press release. "As part of the condition, they also have lower levels of acetylcholine, a chemical which helps us to concentrate — making it extremely difficult to pay attention to walking.”

Rivastigmine was already known to work in dementia patients by preventing the breakdown of acetylcholine, but this study found that it may also “improve regularity of walking, speed, and balance,” making it potentially helpful for Parkinson’s patients.

For their study, Dr. Henderson and her University of Bristol team enrolled 130 people with Parkinson’s who had fallen in the past year. Half were given rivastigmine over an eight-month period. The other half received a placebo.

The patients in the rivastigmine group had improved stability and a reduction in falls. Dr. Henderson and team said this makes rivastigmine a worthwhile candidate for more research. Still, the patients taking rivastigmine reported more gastrointestinal side effects (like nausea and vomiting) than the patients taking the placebo.

Dr. Arthur Roach, director of research at Parkinson’s UK, emphasized the need for more research on this subject.

"Things that may be simple to us, such as walking upstairs or getting up in the middle of the night to get a glass of water, or go to the toilet, are much harder and more dangerous when you could easily fall," Dr. Roach, who was not involved in the current study, said in a press release. "You risk breaking bones and then needing an emergency hospital admission.”

Drugs used to treat other diseases may be tested for their effectiveness in treating Parkinson’s, which could greatly improve the quality of life for patients, Dr. Roach added.

This study was published Jan. 12 in The Lancet Neurology. One of the study authors co-invented a fall risk assessment tool. Novartis supplied the drugs used in this study.

Review Date: 
January 12, 2016
Last Updated:
January 13, 2016