Cough Medicine May Treat Parkinson’s Disease

Cough Medicine May Treat Parkinson’s Disease
Cough medicine may help those with Parkinson's disease. (Shutterfly)
George Citroner
1/27/2023
Updated:
4/25/2023
Disability and death due to Parkinson’s disease are increasing faster than for any other neurological disorder in the world, according to data from the World Health Organization. However, Parkinson’s could be treated with an inexpensive over-the-counter (OTC) cough medicine if a new phase 3 trial is successful.

Current Treatment Limited to Two Drugs

Parkinson’s disease is a degenerative neurological disorder with four primary symptoms: tremors, muscle stiffness, slowness of movement, and impaired balance and coordination.

Parkinson’s disease occurs most often in men older than 50 with certain hereditary factors.

“There is still no treatment or medication known to prevent Parkinson’s disease,” Dr. Jonathan J. Rasouli, director of complex and adult spinal deformity surgery for the department of neurological surgery at Staten Island University Hospital, told The Epoch Times.

It’s thought that Parkinson’s disease develops because of the breakdown or death of nerve cells in a part of the brain that controls movement, the substantia nigra. These cells produce the essential neurotransmitter dopamine and stop when impaired or destroyed.
The disease might also involve damage to nerve endings that produce norepinephrine, another neurotransmitter.

Treatment options for the disease are limited to a combination of two drugs: carbidopa and levodopa. Treatment is expensive and not easily accessed in many parts of the world.

“Most medications on the market basically act like dopamine and improve the main symptoms of Parkinson’s disease,” Rasouli said. “However, these medications have a bunch of side effects, which can be very unpleasant.”

There are also surgical options.

The “gold standard” surgical option is deep brain stimulation surgery, in which a neurosurgeon places special electrodes in the brain.

“Although these treatment options help reduce side effects, they do not stop progression of the disease,” Rasouli said. “Therefore, we have been increasingly looking for treatment options that can stop or even reverse the symptoms of Parkinson’s disease.”

Ambroxol Shows Promise in Phase 2 Trial

Research published in 2009 looked at the cough medicine ambroxol to treat another neurological condition, Gaucher disease, which leaves people deficient in an enzyme called glucocerebrosidase (GCase).
The U.S. Food and Drug Administration still hasn’t approved ambroxol for prescription or OTC use in the United States because it was associated with 10 infant deaths in Arizona more than 10 years ago.

The findings indicated that ambroxol significantly increased levels of GCase in patients living with Gaucher disease.

This caught the attention of Parkinson’s disease researchers.

Reduced levels of GCase have been associated with Parkinson’s disease, as up to 12 percent of people with the condition are born with a gene mutation linked to low levels of this crucial enzyme. Many patients without this mutation also show unusually low levels of GCase.
GCase is used by the brain to clear toxic proteins, such as alpha-synuclein, which is a biomarker for Parkinson’s disease.

If ambroxol increases GCase activity, could it treat Parkinson’s?

A phase 2 human trial found that ambroxol was safe at doses high enough to cross the blood-brain barrier and increase GCase levels by about 35 percent.

Research published in 2020 shows that the drug also lowered levels of alpha-synuclein in Parkinson’s patients and potentially improved motor symptoms.

Rasouli finds the ambroxol study “interesting.”

“The study demonstrated that ambroxol, a cough medicine that can potentially activate enzymes that protect against Parkinson’s disease, was able to get from our stomachs to our brain safely and without major side effects,” he said. “This is what we call a ‘proof of concept’ trial.

“They are now starting to do larger clinical studies this year to see if ambroxol actually works to stop Parkinson’s disease.”

The phase 3 trial begins this year in the UK.

The trial will be conducted in a partnership involving the UK charity Cure Parkinson’s, the Van Andel Institute, a Michigan-based research facility, and the John Black Charitable Foundation.
Researchers will recruit 330 Parkinson’s disease patients and follow them at 10 to 12 locations in the UK.
They'll accept Parkinson’s patients who have mutations in the GBA-1 gene, the most frequent genetic risk factor for the disease, and patients without this risk factor.

Each participant will be given either ambroxol or a placebo for the trial period.

“This will be the first time a drug specifically applied to a genetic cause of Parkinson’s disease has reached this level of trial,” lead researcher of the trial, professor Anthony Schapira at the University College London Queen Square Institute of Neurology, said in a statement.

Ways to Relieve Parkinson’s Symptoms at Home

Although a cure remains to be found, studies have revealed that certain therapies can reduce symptoms of Parkinson’s.
A 2012 study of different types of exercise found that the ancient Chinese art of tai chi produced a measurable improvement in balance and stability in those with moderate Parkinson’s disease.
Research published in 2016 suggests that massage can also help relieve the muscle stiffness and rigidity often found in Parkinson’s patients. Massage therapy treatment reduced resting and postural tremors in a single patient with long-standing Parkinson’s.

Although the therapy was effective in temporarily reducing muscle rigidity during treatment, it didn’t offer a lasting effect.

However, massage does help reduce stress, promote relaxation, and enable you to identify tension in your body, a key step if you’re to find ways to minimize or reduce it. Tension can make symptoms worse, so it’s important to keep it under control.

A systematic review of studies was published in Frontiers in Neurology in 2020 that found that acupuncture for the treatment of Parkinson’s disease may be clinically effective and safe.

“Acupuncture may contribute to recovery from functional impairments following brain damage by encouraging neural stem cell proliferation, which is active at the initial stage of injury,” the review authors wrote.

There’s good evidence that taking certain vitamins might also reduce the risk of Parkinson’s disease, according to a 2002 study published in the journal Neurology.

According to the study authors, one theorized cause of Parkinson’s is brain cell damage from a chemical reaction called oxidation.

“Because vitamins C and E and carotenoids prevent damage from oxidation, they might reduce the risk of developing [Parkinson’s disease],” the study reads.
George Citroner reports on health and medicine, covering topics that include cancer, infectious diseases, and neurodegenerative conditions. He was awarded the Media Orthopaedic Reporting Excellence (MORE) award in 2020 for a story on osteoporosis risk in men.
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