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Treatments and drugs
By Mayo Clinic staffNo cure exists for progressive supranuclear palsy. However, certain medications and other measures can help improve some symptoms of this disorder.
Medications
- Parkinson's disease medications. These include carbidopa-levodopa (Sinemet, Parcopa), dopamine agonists, and amantadine, which increase levels of dopamine — a chemical that transmits signals between areas of your brain to allow smooth, controlled muscle movements. These medications may help improve slowness, stiffness and balance problems for some people. However, the effectiveness of the drugs is limited and usually temporary, lasting about two to three years.
- Certain antidepressants. Antidepressant drugs, including fluoxetine (Prozac), imipramine (Tofranil) and amitriptyline, may improve symptoms of progressive supranuclear palsy. How they do this is not known; the benefits don't seem to be related to their ability to treat depression.
- Botulinum toxin (Botox). This purified form of botulinum toxin may be injected into the muscles or tissue around your eyes. When injected in small doses into specific muscles, Botox blocks the chemical signals that cause muscles to contract, which can improve eyelid spasms.
- Experimental drugs. Researchers are investigating the effectiveness of various drugs in treating progressive supranuclear palsy, notably the dietary supplement coenzyme Q-10. A small trial showed modest success for this nonprescription drug in improving the signs of this condition. Other drugs undergoing trials include lithium, valproic acid and davunetide.
Therapies
- Eyeglasses with bifocal or prism lenses. These aids may help alleviate problems with looking downward.
- Speech and swallowing evaluations. Conducted by a speech therapist, these evaluations can help the therapist advise you on safer swallowing techniques.
- Physical therapy and occupational therapy. These therapies can help improve balance to avoid falls and to help with daily living activities.
References
- Progressive supranuclear palsy fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/psp/detail_psp.htm. Accessed Dec. 14, 2010.
- Dickson DW, et al. Neuropathology of variants of progressive supranuclear palsy. Current Opinion in Neurology. 2010; 23:394.
- Ropper AH, et al. Degenerative diseases of the nervous system. In: Ropper AH, et al. Adams and Victor's Principles of Neurology. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/content.aspx?aID=3639296&searchStr=progressive+supranuclear+palsy. Accessed Dec. 14, 2010.
- Hyun JH, et al. Behavioral changes as the earliest clinical manifestation of progressive supranuclear palsy. Journal of Clinical Neurology. 2010;6:148.
- Golbe LI. Progressive supranuclear palsy: Some answers. CurePSP. http://www.psp.org/about. Accessed Dec. 14, 2010.
- Stamelou M, et al. Short-term effects of coenzyme Q10 in progressive supranuclear palsy: A randomized, placebo-controlled trial. Movement Disorders. 2008;23:942.
- Josephs KA (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 29, 2010.
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