Looking Out For Side Effects If You’re A Carer
If youre a carer of someone with Parkinsons, medication side effects can be difficult and tiring to cope with.
It may be that the person having side effects such as hallucinations and delusions or impulsive and compulsive behaviour does not realise they are experiencing them.
Its important to seek help from your specialist as soon as you can.
Keep A Journal Of Motor Symptoms
Having a detailed record of your motor symptoms can help your neurologist figure out the relationship between your Parkinsons symptoms, your medications, and any side effects you are experiencing. Keep notes in your journal about:
- When you take Parkinsons medications
- The timing of meals, drinks, supplements, and any other medications
- Whether certain foods or drinks seem to affect symptoms
- On times when symptoms are well-controlled
- When symptoms appear, and which symptoms you notice specifically during the day or night
This information can help your doctor better understand your motor fluctuations and provide accurate health care. After living with PD for five years, I started to keep a journal, explained one MyParkinsonsTeam member. I enter the day and time I take my meds. On bad days, when I can take an extra dose of my PD meds, the extra med is in red. On good days, all my times are in black. I took my journal to the doctor last week. Just looking through, he could see if any adjustments are needed. He encouraged me to keep it up!
I Am Going Into Hospital For A Planned Admission And I Want To Make Sure I Get My Medication On Time How Can I Do This
Many hospitals will allow you to take your medication yourself during your stay. You can check this before you are admitted. Some hospitals dont allow patients to take their own medication and it has to be given to you by the ward nurse. If this is the case in the hospital you are going to make sure they know that you need your medication at times which are specific to you and your condition. Your Parkinsons nurse could help you arrange this.
When you go into hospital for a planned operation, you will often have a meeting to discuss your needs, known as a pre-operation assessment. This is a good time to tell medical staff that you need your medication at specific times and that you cant miss a dose.
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Before Taking Rasagiline For Parkinson’s Disease
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking rasagiline it is important that your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breastfeeding.
- If you have a problem with the way your liver works.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
Taking Care Of Business
The Parkinson’s Foundation has developed a thorough guide to getting your household and personal documents organized at www.parkinson.org
- Organize your medical histories
- Keep a journal of medications and dosages
- Organize your personal financial documents
- Insurance and long-term care plans
- Livings wills, durable power of attorney, advanced medical directives
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Keep A Medicine And Symptoms Diary
Keeping a diary can help you to monitor your condition and keep track of your medicines. A diary can be a useful way of letting your doctor know what problems youre experiencing, any changes in your condition from day-to-day or over a period of time, and how well your medicine is controlling your symptoms. It can also help remind you of things you want to discuss during your appointment that you may otherwise forget. You can also use it to record any embarrassing issues that you want help with but find difficult to ask about. Here is some advice on the type of information you might want to keep track of if you have Parkinson’s yourself, or if you are caring for somebody else with Parkinson’s.
Important Points About The New Medications
With multiple new medications available for the treatment of PD, there is more hope than ever that Parkinsons symptoms can be successfully managed for many years. A few things to consider:
- For people whose symptoms are difficult to control, these new treatments are welcome additions to what was previously available and many people with PD have been using these new medications with significant benefit.
- On the other hand, many of the newly-approved medications have the same mechanisms of action as older medications so they are not breaking new ground in treating symptoms.
- In addition, for some people, the effect on symptoms may be mild or not substantial.
These caveats may mean that your physician has not suggested a medication change for you. It is also important to note that despite all the new medications, carbidopa/levodopa remains the most potent medication to treat the motor symptoms of PD.
If your doctor does choose to try one of the new options, there may be multiple paths that your doctor can take when contemplating a medication adjustment. Often trial and error is the only way to determine the best medication regimen for you, so you may need to practice some patience as you work together with your doctor to determine what works or doesnt work.
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Carbidopa/levodopa: Most Efficacious And A Good First Choice
The advent of carbidopa/levodopa nearly 4 decades ago was associated with substantially increased longevity, documented in multiple studies of PD cohorts, and presumably due to mobilizing akinetic patients. This drug remains the most efficacious treatment. Although new PD drugs are sometimes advocated for initial treatment, they are much more expensive and, for seniors with PD, have few advantages over carbidopa/levodopa.
The oral dopamine agonists pramipexole and ropinirole are the primary alternatives to carbidopa/levodopa as initial treatment. They are efficacious but substantially less so than levodopa., Moreover, they have troublesome adverse effects, including sedation/sleep attacks and pathological behaviors, plus an approximately 3-fold risk of hallucinations, compared to carbidopa/levodopa., Uncommonly, PD patients sometimes experience massive lower limb edema provoked by agonists., The primary argument for starting therapy with these agonists is to reduce dyskinesia and motor fluctuation risks in early PD . However, during the early years of PD in seniors, dyskinesias and motor fluctuations are not very frequent and usually are unimportant problems.- Of course, the opposite is true in very young people with PD disease onset before age 40 years is nearly always associated with at least some dyskinesias by 5 years of levodopa treatment. However, PD onset before age 40 years is extremely uncommon.
If I Cannot Take A Particular Medicine Are There Others That Are Equally Good
Some medications interact with others so you should always discuss any change in medication with your doctor so that together you can find a substitute that works for you.
Most medications have two names. One is a generic name that always uses a small letter and describes the active ingredient in the medication, for example co-careldopa. This is likely to be the same name no matter what country you live in. The other is a brand or trade name by which the medication is marketed. This can vary from country to country and always uses a capital letter, for example Sinemet.
See also Types of medication.
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Are There Any Possible Long
As with any medication, there can be long-term effects, although not every person who takes the medication will experience them. Each medication comes with an information leaflet which outlines possible effects so make sure that you read this. If you have any concerns, please discuss these with your doctor, health professional or pharmacist.
See also Managing medication.
What Are Surgery Options For Parkinson’s Disease
Depending upon your needs, medical history, health, and symptoms, one of the following procedures may be considered for Parkinson’s disease:
There are many other procedures being researched. One of the most promising involves the transplantation of fetal dopamine neurons into the brains of people with Parkinson’s disease. The hope is that these cells will be able to re-grow the damaged dopamine-producing nerve cells.
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How I Treated My Own Brain Deterioration
Everything I did to restore my own brain health I learned from a natural health practitioner called Jodi Knapp.
I discovered Jodi on a local health forum some years ago. She works with people using natural approaches to reverse illnesses which were caused by natural causes.
Which is, in fact, almost every illness known to man.
Her philosophy is simple: disease always has a cause.
If I have pain, a deterioration or some painful or deadly affliction there are reasons why I have it.
It doesnt just happen.
Understand those reasons and we have ways of reversing whats gone wrong.
Jodis incredible success rate at treating allegedly untreatable illness comes from her starting at the illnesses first causes.
Those causes are always natural causes. She tackles them and changes lives.
Alternative Treatments For Parkinson’s Disease
Alternative therapy may also be used to treat Parkinson’s disease. The most touted in recent years has been the effect of Vitamin E on reversing the progression of the disease although, this effect is still being debated by the scientific community.
Relaxation and guided imagery have also been suggested to help with stress, depression, and anxiety. Medical studies have shown that relaxation and guided imagery may help slow the progression of symptoms as well as quicken healing time after surgeries or injuries.
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What Side Effects Should I Be Aware Of And What Can I Do To Reduce Them
As with any medication, there can be side effects and these may differ from one medication to another. Each persons reaction to a medication is individual and many experience little or no side effects.
Each prescribed medication has an information leaflet that outlines possible side effects and it is very important that this leaflet is read prior to taking the medication. If you have any concerns, please ensure that you discuss these with your doctor, health professional or pharmacist as soon as possible so that they can advise or change the medication if necessary.
It is important to follow the instructions you are given for taking each individual medication, as some should be taken in a different way or at a different time of day to another. By following this advice you can minimise side effects. Taking the correct dose, on time, is also very important.
See also Managing medication.
Sinemet With Other Drugs In Parkinsons Disease Treatment
For PD treatment, your doctor may recommend an additional drug with Sinemet if youre experiencing off-time while taking Sinemet.
During off-time, you have symptoms of PD or parkinsonism when your dose of Sinemet begins to wear off. This typically happens before youre scheduled to take your next dose of the drug. During these times, symptoms of your condition may return. These include muscle rigidity and tremors .
If youre having off-time while taking Sinemet, your doctor may recommend that you take another medication in addition to Sinemet. This added medication may help decrease your off-time.
Some examples of drugs that may be used with Sinemet to treat off-time include:
- istradefylline
- inhaled levodopa
Your doctor will discuss PD treatment options with you. Theyll recommend which medications you should take and what the drugs do to help your condition. If you have questions about your treatment plan, talk with your doctor.
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Guidelines To Take These Medicines
Patients should essentially follow a few important guidelines to take medicines, as mentioned by their doctors.
- You should never split the pills unless your doctor recommends doing so.
- You should drink about 6 to 10 glass of water in one day.
- Physical activities and warm baths help in fast digestion and absorption of the medicine.
- You should take medicines exactly in the same manner, as your doctor prescribed you to do so, while you should never stop taking it on your own.
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Want More Practical Articles Like This
Much more can be found in our Every Victory Counts® manual. Its packed with up-to-date information about everything Parkinsons, plus an expanded worksheets and resources section to help you put what youve learned into action. Request your free copy of the Every Victory Counts manual by clicking the button below.
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What Are The Implications
According to this research, levodopa is unlikely to affect the progression of Parkinsons disease in the first year and a half following diagnosis.
Symptoms had improved to the same extent by 80 weeks and side effects were similar, suggesting people can start treatment as early as they need to for symptomatic relief.
This supports current practice in giving levodopa when clinically needed. There is no cure for Parkinsons disease, and further research is in progress to develop disease-modifying agents.
Do Not Abruptly Discontinue Medications
Never abruptly discontinue antiparkinsonian medications. Serious reactions, such as neuroleptic malignant-like syndrome, can occur when antiparkinsonian medications are discontinued or the dose of levodopa has been reduced abruptly. This can result in a high fever, sweating, unstable blood pressure, stupor, muscular rigidity, and autonomic dysfunctions that can be life threatening.
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What Is Step Therapy
This is a real-life scenario, known as step therapy, that countless people living with Parkinsons experience each year. Having been told that a drug like GOCOVRI, the medication mentioned above that is the only FDA-approved drug for OFF or dyskinesia, or both, many people living in the US are not given immediate coverage of the medication. Instead, they have to wait to see if another drug is helpful in treating their symptoms. Importantly, this other drug may not be approved or indicated to treat this symptom.
Sometimes known as the fail first process, step therapy requires a person to first fail on a lower-tier medication before their insurer will cover the higher tier drug, which typically is more expensive for the insurer to cover.
Step therapy processes and rules can vary in terms of how many steps are required. Sometimes a person is required to fail first with only one lower-cost medication, while other coverage decisions require a person to fail first trying multiple medications.
Lets take a look at our real-life example. If a person with Parkinsons is prescribed GOCOVRI, they cant just head to their pharmacy and pick up a prescription for GOCOVRI. First, they must try amantadine immediate release, which is not approved for either dyskinesia or OFF. For some people with Parkinsons, this may provide symptom relief. For many people with Parkinsons, however, an immediate-release amantadine will not minimize OFF while also minimizing dyskinesia.
Making The Most Of On Time
Although there are many approaches to managing off time, it often becomes harder to control motor fluctuations over time. Once you get a sense of when your off times are likely to occur possibly with the help of a motor symptom journal you can better plan your day. Take advantage of on times when symptoms are well-controlled to be active, and try to make sure off times happen at times when it matters less.
Each persons daily schedule will look different based on when off time occurs which may be as a dose of Parkinsons medication wears off, in the morning before the first dose, or while waiting for a dose to take effect. It may also depend on other medications you take, whether for Parkinsons or another medical condition.
As you make your schedule, take into account:
- Timing meals for best medication effectiveness
- Getting sunlight and physical activity early in the day if possible
- Minimizing drinking before bedtime to avoid needing to get up to urinate
- Taking any sedating medication later in the day, closer to bedtime
For some MyParkinsonsTeam members, the morning is peak on time. Best time for me is early in the morning, wrote one member. I clean house, do yoga, then have a big breakfast at about 6:30. Another shared, Walked three miles this morning. If I don’t walk in the morning, by the afternoon I’m spent! No energy!
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Sinemet Withdrawal And Dependence
You should never suddenly stop taking Sinemet. Stopping Sinemet suddenly can cause serious side effects called withdrawal symptoms. During withdrawal, you have unpleasant symptoms when you stop taking a drug that your body has become dependent upon.
Suddenly stopping Sinemet or decreasing your dosage can cause a rare but life threatening group of symptoms thats similar to neuroleptic malignant syndrome. Symptoms can include:
- fever
- high or low blood pressure
- rigid muscles
Before you stop taking Sinemet, be sure to talk with your doctor. They may slowly reduce your dosage of the drug so that your body can adjust to the change. Slowly reducing your dosage decreases your risk of withdrawal symptoms.
What To Do In Case Of Overdose
If you think youve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.
Here are answers to some frequently asked questions about Sinemet.
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If I Forget To Take A Dose Of Medication What Should I Do
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If you forget to take your dose, take it as soon as you remember and then adjust the time of your next dose. For example, if you normally take doses at 8am, 12pm, 4pm and 8pm and you forget your midday dose until 2pm, take it then and adjust your next doses to 6pm and 10pm.
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Do not take two doses together to make up for a dose that you forgot to take or take your late dose really close to your next one. This is because you might experience side effects including nausea or dizziness.
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If you are taking a once daily medication and you forget a dose, you can still take the dose if you remember on the same day. But, if you dont remember until the following day you shouldnt double up your dose.
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If you forget your medication you may experience increased Parkinsons symptoms. It can happen on the same day or the day after, so make sure you are careful about driving your car or using machinery.