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A Review of the Clinical Evidence for Complementary and Alternative Therapies in Parkinson’s Disease

Opinion statement

No conventional treatment has been convincingly demonstrated to slow or stop the progression of Parkinson’s disease (PD). Dopaminergic therapy is the gold standard for managing the motor disability associated with PD, but it falls short of managing all of the aspects of the disease that contribute to quality of life. Perhaps for this reason, an increasing number of patients are searching for a more holistic approach to healthcare. This is not to say that they are abandoning the standard and effective symptomatic therapies for PD, but rather are complementing them with healthy living, mind-body practices, and natural products that empower patients to be active participants in their healthcare and widen the net under which disease modification might one day be achieved. Despite high rates of utilization of complementary and alternative medicine (CAM) practices, data on efficacy is generally limited, restricting physicians in providing guidance to interested patients. Exercise is now well-established as integral in the management of PD, but mind-body interventions such as Tai Chi that incorporate relaxation and mindfulness with physical activity should be routinely encouraged as well. While no comment can be made about neuroplastic or disease-modifying effects of mind-body interventions, patients should be encouraged to be as active as possible and engage with others in enjoyable and challenging activities such as dance, music therapy, and yoga. Many PD patients also choose to try herbs, vitamins, and neutraceuticals as part of a healthy lifestyle, with the added expectation that these products may lower free radical damage and protect them against further cell death. Evidence for neuroprotection is limited, but patients can be encouraged to maintain a healthy diet rich in “high-power,” low-inflammatory foods, while at the same time receiving education that many promising natural products have produced disappointing results in clinical trials. It is vital that the science of holistic medicine reaches a point where all neutraceuticals are investigated with the same rigor as conventional drugs. A number of agents discussed here that have a proposed role in the treatment of neurodegenerative diseases (and PD in particular), including cannabis, mucuna pruriens, and Chinese herbals, deserve more attention from basic science researchers and clinical investigators before they can be either safely utilized or dismissed.

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Compliance with Ethics Guidelines

Conflict of InterestDanny Bega has received a junior investigator award from the Northwestern University Parkinson’s Disease Advisory Council to study the efficacy of yoga in Parkinson’s disease.

Paulina Gonzalez-Latapi declares no conflict of interest.

Cindy Zadikoff has served as a paid consultant for UCB Pharma, AbbVie, and Merz. She has also served as a paid speaker for Teva and GSK.

Tanya Simuni has served as a paid consultant and has received honoraria from Novartis, Ibsen, General Electric, UCB Pharma, TEVA, IMPAX, Merz, Boehringer Ingelheim, National Parkinson Foundation, and GSK (terminated April 2009). She has also received research support from NIH, MJ Fox Foundation, TEVA, IMPAX, National Parkinson Foundation, and Northwestern Memorial Foundation.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Danny Bega MD.

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This article is part of the Topical Collection on Movement Disorders

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Bega, D., Gonzalez-Latapi, P., Zadikoff, C. et al. A Review of the Clinical Evidence for Complementary and Alternative Therapies in Parkinson’s Disease. Curr Treat Options Neurol 16, 314 (2014). https://doi.org/10.1007/s11940-014-0314-5

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Keywords

  • Parkinson’s disease
  • CAM
  • Complementary and alternative therapy
  • Mind-body
  • Tai chi
  • Dance
  • Music therapy
  • Yoga
  • Biofeedback
  • Guided imagery
  • Behavioral therapy
  • Acupuncture
  • Massage
  • Neutraceuticals
  • Vitamin E
  • Coenzyme q10
  • Creatine
  • Glutathione
  • Uric acid
  • Mucuna pruriens
  • Cannabis
  • Herbals
  • Traditional Chinese medicine