Complementary Therapies for Parkinson's Disease: What's Promoted, Rationale, Potential Risks and Benefits

Nearly half of all patients with Parkinson's disease (PD) utilize some form of complementary therapy often identified on the Internet and frequently not reported to their physicians. Treating physicians are sometimes unaware of such treatments, including their rationale, mechanisms, potential efficacy, and potential adverse effects.

Methods for this study included systematic Internet search of products recommended for PD, medical literature review to determine scientific rationale, any evidence of efficacy, and potential risks.

A large number of complementary therapies are recommended for patients with PD, generally falling into the following categories: dietary and nutritional; chelation; and physical. Most have reasonable justifications based on mechanism of action and current theories on causes of neurodegeneration in PD, but few have documented evidence of benefit. Fortunately, most have few risks and side effects, although some are very expensive. The protein redistribution diet has substantial evidence of symptomatic benefit. Some antioxidative or -inflammatory supplements, aerobic exercise, Tai chi, and dance and music therapy have preliminary evidence of symptomatic benefit or potential neuroprotective effects, but more research is needed to establish efficacy.

Patients with PD are faced with many recommendations for complementary therapies. Physicians should know about these in order to have informed discussions with their patients. Some deserve further study.