and blogs are the Official Website for the books:  Parkinson's Treatment: 10 Secrets to a Happier Life and 10 Breakthrough Therapies for Parkinson's Disease.

Dr. Okun is the co-founder of the University of Florida Center for Movement Disorders and Neurorestoration, the National Medical Director for the National Parkinson Foundation, as well as the author of several books including Ask the Expert about Parkinson's Disease, Lessons from the Bedside, 10 Breakthrough Therapies for Parkinson's Disease and Parkinson's Treatment: 10 Secrets to a Happier life due out in 2013.  His secrets book was translated into 20 languages so that it can be made available to Parkinson's disease sufferers around the world.  Dr. Okun has been recently been honored at the White House as a Champion of Change for Parkinson's Disease. Dr. Okun has been published in journals such as the New England Journal of Medicine and people travel from around the world to seek his opinion on best treatment approaches for this disease.

Everything I need to know about Duodopa and continuous dopamine pumps for Parkinson's disease

The Dream of a Pill Free Existence and the Continuous Dopaminergic Pump for the Treatment of Parkinson’s Disease

Could there be a pill free existence with Parkinson's disease?  Enter the dopamine pump technology....

How does it work?

- A strategy that offers the possibility of constant stimulation of the brain’s dopamine receptors through the use of a continuous dopamine infusion pump technology. 

- A recent trial was published in Lancet Neurology.

-The trial utilized an intrajejunal (i.e. a tube inserted in the small intestine) levodopa-carbidopa intestinal gel pump infusion strategy, and it was designed to collect safety and effectiveness data

- The study was double blind (neither the patients nor the raters knew what was administered) and randomized.  

- The article reveals that participants were randomized (1:1) to “immediate-release oral levodopa-carbidopa pills plus a placebo intestinal gel infusion or to levodopa-carbidopa intestinal gel infusion plus oral placebo pills.”  It is important to remember that everyone in the study received a pump, but half of the patients did not receive active therapy (through the continuous pump infusion).

-  Off-time improved by 4 hours in the pump group versus 2.1 hours in the pill group

- "On” time without troublesome dyskinesia was better in the pump group when compared to the pill group

- The pump is approved and available in 43 countries but not yet in the USA  

- The study did not enroll patients with severe dyskinesia, and we still don't know the exact profile for the best pump patients

- The gatrojejunostomy (small feeding tube) presents the biggest challenges and complications

- Complications with the tube and hardware were present in 89% of subjects but were mostly addressable

- The pump requires wearing an external device, and it also requires changing a dopamine cassette once or twice a day

- Some will need additional medications during the bedtime hours. 

- Pumps require continuous maintenance and programming 

- An important next step will be a comparison to deep brain stimulation

- Pumps are exciting but not cures

 For more detailed information read Dr. Okun's monthly what's hot in Parkinson's disease column on the NPF website.