From the Research
Hyoscine butylbromide is not recommended for treating Parkinson's disease and may actually worsen symptoms. As an anticholinergic medication, hyoscine butylbromide blocks acetylcholine receptors, which can exacerbate the existing neurotransmitter imbalance in Parkinson's disease. Parkinson's is characterized by dopamine deficiency, and the delicate balance between dopamine and acetylcholine is crucial for normal movement. By blocking acetylcholine, this medication can increase cognitive impairment, confusion, hallucinations, and worsen motor symptoms in Parkinson's patients.
Key Considerations
- The most effective pharmacologic intervention used to treat motor symptoms in Parkinson's disease is levodopa, which is available in various formulations, including newer continuous subcutaneous infusions 1.
- Anticholinergics like hyoscine butylbromide can cause troublesome side effects including dry mouth, blurred vision, urinary retention, and constipation, which are particularly problematic for elderly patients with Parkinson's who may already experience these issues.
- If a Parkinson's patient requires treatment for gastrointestinal spasms (the primary use of hyoscine butylbromide), alternative medications with fewer central nervous system effects should be considered, and any medication decisions should be made in consultation with a neurologist familiar with managing Parkinson's disease.
Treatment Options
- Dopamine agonists, monoamine oxidase-B enzyme inhibitors, catechol-O-methyltransferase enzyme inhibitors, amantadine, istradefylline, and anticholinergics can be used as adjuncts to levodopa 1.
- With disease progression, pharmacologic interventions alone may not suffice to manage motor symptoms, making it necessary to consider device-aided therapies or invasive surgical techniques 1.
Recent Studies
- A 2020 study compared the effectiveness of dopamine agonists and monoamine oxidase type-B inhibitors for Parkinson's disease, finding that all investigated drugs were effective compared with placebo when given as monotherapy except safinamide 2.
- A 2014 study found that very small but persistent benefits are shown for patient-rated mobility scores when treatment is initiated with levodopa compared with levodopa-sparing therapy 3.