Delayed Administration And Contraindicated Drugs Place Hospitalized Parkinsons Disease Patients At Risk
Problem: One-third of all patients with Parkinson’s disease visit an emergency department or hospital each year, making it a surprisingly common occurrence.1 The disease affects about 1 million people and is currently the fourteenth leading cause of death in the US. Hospitalization can be risky for patients with Parkinson’s disease when viewed from the perspective of pharmacological management.
Patients with Parkinson’s disease require strict adherence to an individualized, timed medication regimen of antiparkinsonian agents. Dosing intervals are specific to each individual patient because of the complexity of the disease. It is not unusual for patients being treated with carbidopa/levodopa to require a dose every 1 to 2 hours. When medications are not administered on time, according to the patient’s unique schedule, patients may experience an immediate increase in symptoms.2,3 Delaying medications by more than 1 hour, for example, can cause patients with Parkinson’s disease to experience worsening tremors, increased rigidity, loss of balance, confusion, agitation, and difficulty communicating.2 Studies show that three out of four hospitalized patients with Parkinson’s disease do not receive their medications on time, or have had doses entirely omitted.4 According to the National Parkinson Foundation, 70% of neurologists report that their patients do not get the medications they need when hospitalized.2
Two case examples
Other medication safety concerns
References
Tips For People With Parkinsons Who Want To Take Over The Counter Medications During Flu Season
People with PD often tell us that when they get sick with cold and flu-like symptoms, their pharmacist and healthcare professionals warn them to stay away from the medication aisle of the pharmacy. They are told that any over-the-counter medication has the potential to worsen Parkinson’s symptoms. Unfortunately, many people interpret this potential worsening as a recommendation to never use these medications.
Also contributing to this issue is a series of reports that medications such as anticholinergics may cause acute confusion and even contribute to long-term cognitive changes. It is important to keep in mind when selecting a cough or flu medication that the intent is not to treat long-term issues.
This flu season we wanted to provide the PD community with some tips to help you navigate Parkinson’s while simultaneously addressing cold and flu symptoms:
In 2014, Kim Painter wrote a great article in the USA Today to help individuals and families stay safe in the cold and flu aisle.
Here are some of Kim’s tips:
- Treat only symptoms you have and be wary of multi-symptom products.
- Know your dose and don’t overdose.
- Know your health risks .
- Don’t double up and accidentally take two medicines with similar ingredients.
- Consider trying alternatives .
Serotonin Reuptake Blocking Antidepressants Fluoxetine Sertraline And Paroxetine
Several other medications have been reported to cause drug-induced parkinsonism and to worsen parkinsonism in people with Parkinson disease, including the serotonin reuptake blocking antidepressants fluoxetine, sertraline, and paroxetine. Two calcium channel blockers available in Europe and South America , which are piperazine derivatives, are thought to cause drug-induced parkinsonism by blocking dopamine receptors. Reports of parkinsonism induced by other drugs, such as lithium and amiodarone, are so rare that only after parkinsonism has developed should the possible drug effect be taken into account. Because lithium is not known to block dopamine receptors, another mechanism is likely. Some animal data implicate an effect of lithium on intercellular signalling via G-protein coupled receptors . One antidepressant, amoxapine, has dopamine receptor-blocking properties and, therefore, may induce parkinsonism. Parkinsonism as a transient side effect of alcohol withdrawal has been reported without later development of Parkinson disease, but it is unknown how common this is .
Any Medication That Blocks Dopamine In The Body Can Cause Parkinsons Symptoms
You may have heard of Parkinson’s disease , a movement disorder. Someone with it may have characteristic signs, such as a pill-rolling tremor in the fingers or a hunched forward posture. You may recognize someone with this disease from the faltering, tiny steps they take when they walk or by their rigidly emotionless face.
The cause of Parkinson’s disease is mostly unknown. Some people develop Parkinson’s-like symptoms after treatment with certain medications. This is called drug-induced parkinsonism or secondary parkinsonism. Certain medications can also worsen symptoms in someone who already has Parkinson’s disease.
Any medication that blocks dopamine in the body can cause Parkinson’s symptoms. Dopamine is a brain chemical that helps control movement. Common dopamine-blocking drugs are antipsychotics. They are used to treat certain mental illnesses or severe nausea. Less commonly, certain types of calcium channel blockers cause drug-induced parkinsonism. These drugs may be used to treat chest pain and high blood pressure, or irregular heart rate.
A Common Cough Syrup Drug Just Passed Another Trial As Parkinson’s Treatment
A drug first discovered over 50 years ago and long used as a medicine for coughs and respiratory illnesses appears to show promise in treating a very different kind of sickness: Parkinson’s disease.
Ambroxol, an active ingredient in cough mixtures since the 1970s, has been investigated in recent years for its apparent potential to halt the progression of Parkinson’s, and already this year, the drug has passed two important milestones that may bring us closer to a much-hoped-for treatment.
Last month, a multi-institutional team of researchers led by University College London reported the results of a small Phase II clinical trial suggesting that ambroxol was safe and well-tolerated in human patients with Parkinson’s disease, while hinting at possible neuroprotective effects that need to be examined further in subsequent trials.
Based on these outcomes, last week funding was announced to continue the next steps in evaluating ambroxol in a much larger cohort of people with Parkinson’s, while also seeking to learn more about how individual patient genotypes may contribute to the disease.
“The ambroxol study is important because there are no treatments available for Parkinson’s that slow, stop, or reverse ” says Simon Stott, deputy director of research at The Cure Parkinson’s Trust, one of the bodies funding the research program.
“All of the current medications only deal with the symptoms of the condition – they do nothing to delay the progression of Parkinson’s.”
What Are The Different Types Of Pain Experienced By People With Parkinsons
Five main types of pain are common for people with Parkinson’s. Multiple types may be present simultaneously or occur at different points throughout a person’s path with Parkinson’s. Recognizing which kind of pain is present can help you optimize treatment, as can paying attention to what activities or times of day make your pain better or worse.
Musculoskeletal pain
Musculoskeletal pain that affects muscles, bones, tendons, ligaments, and/or nerves. The pain can be localized or generalized and can fade or intensify at different times. Existing musculoskeletal pain can be exacerbated by Parkinson’s.
Neuropathic pain
Rather than being caused by a physical injury, this type of pain is caused by damage to the somatosensory nervous system or a disease affecting the somatosensory nervous system, which responds to external stimuli like touch, temperature, and vibration. It tends to be fairly consistent throughout the day and is present no matter what activity you’re doing. Unlike the aching you may feel when you’re doing a strenuous physical activity, neuropathic pain feels more like a tingly, crawly, uncomfortable sensation.
Dystonic pain
Dystonia, the movement disorder in which involuntary muscle contractions cause repetitive or twisting motions, is often very painful. Many people with Parkinson’s experience dystonia as a motor symptom, whether it’s localized , in multiple nearby body parts , or all over .
Akathisia
Central pain
Not All Drugs In These Classes Will Cause Symptoms Of Parkinsonism
What’s the difference?
Drug-induced parkinsonism usually develops on both sides of the body, while typical Parkinson’s disease does not. Also, drug-induced parkinsonism usually does not progress like typical Parkinson’s.
Unlike Parkinson’s, drug-induced symptoms usually go away after the drug is stopped. It may take several months, though, for the symptoms to completely stop. If the symptoms remain, then it is possible that the drug may have “unmasked” underlying Parkinson’s disease.
Who is at risk?
- Female: Women are twice as much at risk as men.
- Elderly: Older people are more likely to be on multiple medications or to have underlying Parkinson’s disease.
- Those with a family history of Parkinson’s disease.
- People with AIDS.
A Critical Reappraisal Of The Worst Drugs In Parkinsons Disease
What are the worst drugs for Parkinson’s disease patients? Couldn’t a simple list be assembled and disseminated to the Parkinson community? Recently Ed Steinmetz, an experienced neurologist in Ft. Meyers, FL pointed out to me, a list approach published in the Public Citizen Newsletter . The approach was to list every drug associated with a single confirmed or unconfirmed symptom of Parkinson’s disease or parkinsonism. Parkinson’s disease is defined as a neurodegenerative syndrome , whereas parkinsonism encompasses a wider net of drug induced and other potential causes. In parkinsonism symptoms are similar to Parkinson’s disease, but patients do not have Parkinson’s disease. Patients and family members confronted with a simple “drug list” approach may falsely conclude that most medicines are bad for Parkinson’s disease, and that any medicine may cause parkinsonism. This concept is in general, incorrect. Although the approach is well-meaning, it is in need of a major revision, as Parkinson’s disease and parkinsonism are too complex to summarize by simple lists. In this month’s column I will try to summarize the key information that patients and family members need to know about the “worst pills,” for Parkinson’s disease and parkinsonism.
A Florida Parkinson’s Treatment Blog by Michael S. Okun, M.D.
UF Center for Movement Disorders & Neurorestoration, Gainesville FL
Tips For People With Parkinsons Who Want To Take Over The
Aspirin, and Metoclopramide , In particular, which occurs naturally in your body, no more than once per OFF period and up to 5 times a day, Promethazine , the involuntary movements that are disabling side effects of taking the Parkinson’s disease medicationParkinson Disease: Tips for Taking Medicines, OFF periods include the return of motor symptoms , It gets the drug quicker into your bloodstream and provides local inflammation reliefWhat is this medicine? CHLOPHEDIANOL; DEXBROMPHENIRAMINE is a cough suppressant and antihistamine, Follow your doctor’s dosing instructions very carefully, How to take Robitussin Dry Cough Medicine 4, It gets the drug quicker into your bloodstream and provides local inflammation relief
Eat Plenty Of Protein But Not With Levodopa Medications
If you’re taking a levodopa medication, your doctor may tell you to avoid protein when taking your meds. Both animal and plant protein can interfere with the absorption of levodopa medications.
But you should still eat plenty of protein. Just be strategic with the timing. “Don’t take levodopa medications with meals,” Dr. Gostkowski says. “It’s best to take it on an empty stomach — either 30 minutes before your meal or an hour after eating.”
If you get nauseous from the medication, eat a small amount of starchy food with it, such as crackers. Make sure whatever you eat with your medicine doesn’t have protein. “It’s a misunderstanding that people with Parkinson’s should avoid protein,” Dr. Gostkowski says. “You definitely need protein in your diet. Just don’t eat it when you’re taking your levodopa medication.”
Cough Syrup Drug Being Trialled As Parkinsons Treatment
14 February 2020
After finding that a drug found in cough syrups may have use as a treatment for Parkinson’s disease, UCL researchers have received funding for the next stage in clinical trials.
Ambroxol, a medication originally designed to clear phlegm and ease coughing for people with respiratory diseases such as bronchitis, is being tested to see if it can slow down the progression of Parkinson’s disease by keeping cells healthier for longer.
A research team led by Professor Tony Schapira reported in January that ambroxol was safe and well-tolerated in 17 study participants with Parkinson’s disease.
According to the findings published in JAMA Neurology, the drug also effectively crossed the blood-brain barrier and increased levels of the glucocerebrosidase protein in the participants’ brain cells. This protein allows cells to remove waste more effectively, a function which evidence suggests is deficient in some people with Parkinson’s. Increasing levels of the protein may have the potential to keep cells healthier for longer and, therefore, slow Parkinson’s progression.
“By increasing levels of GCase, ambroxol allows cells to remove waste, which would ideally keep cells healthier for longer and could slow down the progression of Parkinson’s,” explained Professor Schapira.
The iLCT committee had prioritised ambroxol in 2014.
Cholinesterase Inhibitors Widely Used To Treat Dementia
Cholinesterase inhibitors, widely used to treat dementia, may cause worsened parkinsonism, primarily increased tremor . Large double-blind trials of rivastigmine, a cholinesterase-inhibiting drug, in both dementia with Lewy bodies and Parkinson disease dementia have demonstrated that rivastigmine is well tolerated without significant worsening of motor function overall, although tremor may increase . The other cholinesterase inhibitors have been less well studied but appear to have similar benefits and side effects.
Robitussin Honey Adult Maximum Strength Cough + Chest
If you have a seriously sore throat, there is no better cold medicine than Robitussin Honey Adult Maximum. Each bottle contains more than 19% honey, as well as dextromethorphan and guaifenesin to open up your airways.
What we like: Robitussin Honey Adult Maximum Strength effectively addresses congestion, while relieving your sore throat so you can sleep. It is both high-powered and free of allergens. And it is reasonably affordable.
Flaws: Tastes like medicine. And with the high honey content, it is definitely not for diabetics.
In Case Of Accidents Or If You Need To Go To Hospital
- Keep a record of all the medications you take – both for Parkinson’s and other conditions. Carry it with you in your purse or wallet in case of emergency. Make sure you take this record with you if you go into hospital. If your medication is complicated you could make a chart to track what you take each day.
- Wear a medical alert bracelet or necklace if you want a medical team to know immediately what medications you take in case of an emergency.
- If you stay in hospital make sure staff are aware of the medications you take and the importance of having them on time every time.
The EPDA’s Parkinson’s Passport enables you to complete an information booklet about your medications and treatment and then carry it when you are out and about or travelling abroad.
What Were Fighting For During The Coronavirus Crisis
We’re supporting and sticking up for people with Parkinson’s.
Health, social care, and benefits must meet your needs. Right now, it’s clear that not everyone’s needs are being met. So, we’re listening to your concerns and experiences, and we’re talking to the relevant governments and organisations. We demand they take action, to make sure you’re treated fairly.
What Can I Do On A Regular Basis To Manage My Pain
Remember, you’re your best advocate as you understands how your pain feels. Understanding and communicating the kind of pain you’re experiencing can greatly inform your treatment plan and will allow your doctors to address the type and severity of your specific pain. Keep your care team informed about activities that cause pain or the times of day your pain is worst so they can help fine-tune your care plan. Do you notice the pain starting to creep in at a certain point after you take your medication? Do you feel fine when you bike but experience pain when you jog? Did you start experiencing this pain before or after your Parkinson’s diagnosis? Taking stock of these sorts of questions can be helpful as you work with your care team to effectively treat your pain.
Incorporating approved medications and following the pain ladder can also help you find the right pain management solution, as can taking steps in your everyday life to be an active participant in your own pain management. Regular stretching, heat and cold treatments, exercise, yoga, and dance can all help reduce your pain, and they are all steps that you can take on your own. Making adjustments to your home and workspace, such as minimizing places where fall risks are likely, using an ergonomically designed desk, sleeping in a comfortable bed, and wearing clothes and shoes that don’t exacerbate pain, can help you establish a more pain-free daily routine.
Managing Parkinson’s Medication While In Hospital
Make sure that hospital staff understand you have Parkinson’s and that you need your medication on time when you’re admitted to their ward. Getting your medication on time will mean your symptoms are well controlled and that you are likely to experience fewer complications from being in hospital.
Some hospitals will allow you to look after your own medication, so that you can take it yourself outside of the usual drugs round. Our Get It On Time resources can help you to educate and remind staff about the importance of getting medication on time in hospital.
People with Parkinson’s can have symptoms that aren’t connected to movement problems, known as non-motor symptoms. These include anxiety, pain and constipation. These types of symptoms may be treated with the same drugs used by everyone with that health issue, rather than Parkinson’s-specific drugs. For example, you may be prescribed Movicol for constipation.
Parkinson’s and the drugs used to treat it can interact with the drugs used for other conditions. This means that a particular drug can become weaker or stronger. Your specialist or pharmacist can advise you on this. Always ask them before buying any over the counter medication.
Cough Medicine Fights Dyskinesias In Parkinson’s
- Date:
- Oregon Health & Science University
- Summary:
- A cough suppressant and a drug tested against schizophrenia curb dyskinesias, the involuntary movements that are disabling side effects of taking the Parkinson’s disease medication levodopa, scientists found. Dextromethorphan, used in such cold and flu medications as Robitussin and Sucrets, suppresses dyskinesias in rats. BMY-14802, a drug tested in people with schizophrenia, also suppresses dyskinesias in rats, and does so more effectively than dextromethorphan, suggesting BMY-14802 might block dyskinesias in people with Parkinson’s.
A cough suppressant and a drug tested as a schizophrenia therapy curb the involuntary movements that are disabling side effects of taking the Parkinson’s disease medication levodopa, Portland scientists have found.
Dextromethorphan, used in such cold and flu medications as Robitussin, Sucrets, Triaminic and Vicks, suppresses dyskinesias in rats, researchers at Oregon Health & Science University and the Portland Veterans Affairs Medical Center found. Dyskinesias are the spastic or repetitive motions that result from taking levodopa, or L-dopa, over long periods.
The study, titled “Differential effects of NMDA antagonists and sigma ligands on L-dopa-induced behavior in the hemiparkinson rat,” is being presented during a poster session today at Neuroscience 2007, the 37th annual Society for Neuroscience conference in San Diego.
Story Source:
Managing Parkinson’s Drugs: Tips And Experiences
This video contains tips and experiences from 5 people with Parkinson’s about how they manage their medication.
Everyone’s Parkinson’s is different so remember that for specific medical advice about your treatment regime you should speak to your specialist or Parkinson’s nurse.
Watch the video to get tips and experiences.
Cough Medicine Fights Dyskinesias In Parkinsons
Summary: A cough suppressant and a drug tested against schizophrenia curb dyskinesias, an approved therapy for high blood pressure, but can have side effects , Guaifenesin or for two weeks after stopping an MAOI, but there are still Parkinson’s disease medications to avoid, Therefore, your dose may be different than if you take rasagiline with other Parkinson’s medications, Ask a doctor before using this medicine if you have a chronic coughFrom coughs sore throats and general pain relief, 2020, or Parkinson’s disease or have done so in the last 14 days.If you take rasagiline alone, Answered June 29, is able to promote the clearance of toxic protein aggregates in mouse models of neurodegenerative diseases, Parkinson symptoms are much easier to manage with a good medicine routine, These drugs include Prochlorperazine ,” was published Medication can be extremely helpful to those with Parkinson’s disease, psychiatric, cough drops etc say not to take if you have Parkinson’s, It is used to treat the symptoms of seasonal and year-round allergies, “ Felodipine induces autophagy in mouse brains with pharmacokinetics amenable to repurposing , mucinex) is the only expectorant available, while continuing their regular
Parkinson’s Disease: Frequently Asked Questions
Here are some frequently asked questions related to Parkinson’s disease.
Q: Should I stop my Parkinson’s disease medications before general surgery or an operation?
A: Some neurologists recommend that medications be stopped 12 hours prior to general anesthesia for surgery. If you are on a complicated drug regimen, ask your surgeon prior to surgery to contact the physician responsible for your Parkinson’s disease therapy so that your drugs can be given appropriately.
Q: Can I drink alcohol if I am being treated for PD?
A: A modest intake of alcohol is not a problem for people with Parkinson’s disease. However, medications should not be taken with alcohol, and you should avoid alcohol altogether while you are building up the dose of a new drug.
Q: Are there any vitamins or minerals that cure Parkinson’s disease?
A: Vitamins and minerals certainly contribute to a healthy lifestyle and supplement food intake. However, none have been found to halt the disease process or cure PD.
Q: I have read that I should avoid protein and dairy products in particular?
Q: Do I have to stop my PD meds when I’m taking drugs for another illness?
How Is Pain Treated For People With Parkinsons
No matter the cause, pain is often complex. When a person with Parkinson’s experiences intense pain, especially in combination with other symptoms of Parkinson’s, managing it can be challenging. There are, however, several ways you can adjust your medication regimen, exercise schedule, and lifestyle to reduce your pain and improve your quality of life.
Medications
There are various kinds of medications used to treat pain, especially for people with Parkinson’s. In a recent webinar, Dr. Janis Miyasaki described how physicians approach pharmacological treatment of pain for people with Parkinson’s:
The principle is to start with what is called the pain ladder. You always start with the least intensive, least side effect-giving treatment.Janis Miyasaki, MD
Step one
The first step of the pain ladder is hot and cold treatments along with stretching and flexibility exercises. People who experience rigidity and stiffness can sometimes alleviate pain using heating pads to loosen their muscles, then improve mobility by stretching, then address any residual pain with ice packs.
Step two
Step three
Step four
Step five
Other medical interventions
Who Should I See To Discuss My Parkinsons Pain
Your first point of contact should be your primary doctor. Whether that means your family doctor, neurologist, or Movement Disorder Specialist , start by asking them how to manage your pain. They may prescribe you one of the medications listed above, offer suggestions about altering your lifestyle, or refer you to a pain specialist.
Pain management specialists are physicians with specialized training in the field of evaluating, diagnosing, and treating pain; so, speaking to one of these specialists might be helpful for you. Be sure to get a referral from your primary care doctor, though, to ensure you are visiting a physician who understands the complexity of treating Parkinson’s-specific pain.
Health and wellness providers like physical therapists, acupuncturists, and massage therapists can also be valuable members of your care team. Be willing to try new things and approach alternative therapies with an open mind, as no one’s path with Parkinson’s pain is the same. What works for someone else may not work for you and vice versa. Consider visiting different specialists to find a treatment plan that works best for you.
Which Body Parts Do Parkinsons Tremors Affect
There are five main places you’ll have Parkinson’s tremors:
1. Hands. Parkinson’s disease tremors often start in the fingers or hands with what’s called a pill-rolling motion. Imagine holding a pill between your thumb and index finger and rolling it back and forth.
2. Foot. A Parkinson’s foot tremor is more likely to happen while you’re sitting or lying down with your feet at rest. If the tremor moves into your thigh muscles. It could look like your whole leg is shaking.
Foot tremors disappear when you stand or walk because those are active movements. A foot or leg tremor while you’re standing may be another condition.
3. Jaw. This is common in people with Parkinson’s. It may look like you’re shivering. It can become bothersome if the tremor makes your teeth chatter. If you wear dentures, it could make them shift or fall out.
Chewing eases the tremor, so gum might help.
4. Tongue. It’s rare, but a tongue tremor can cause your entire head to shake.
5. Internal. Some people with Parkinson’s say they can feel a shaking sensation in their chest or abdomen. But can’t be seen from the outside.
Is Mucinex Compatible With Parkinson Disease
topcat1957
Mucinex is the brand name for guaifenesin which is an expectorant, that is it “loosens” up the phlegm in your nose and upper respiratory system.It is considered safe for patients with Parkinson’s disease. It can be combined with most other cold medicines as well. You should avoid combining it with any other medications which also contain guaifenesin however.
+0pjbaum
On the box it says it is not compatible with Parkinson disease. Why would they say that?
topcat1957
As a pharmacist I cannot think of any parkinsons medications it will interact with. I found a Parkinson’s Resource Center website which agrees with me. But there may be another consideration.
It may be that with Parkinson’s disease, in some cases a patient’s cough reflex may be affected. In that case having loose phlegm might be a problem. If a patient cannot cough it up effectively there could be a risk of aspirating it back into the lungs.
This is why it is best to consult your physician always as he is aware of your particular condition, the severity of your disease. So follow his recommendations always.
What Other Drugs Will Affect Diphenhydramine
Ask a doctor or pharmacist before using this medicine if you are also using any other drugs, including prescription and over-the-counter medicines, vitamins, and herbal products. Some medicines can cause unwanted or dangerous effects when used together. Not all possible interactions are listed in this medication guide.
Taking this medicine with other drugs that make you sleepy or slow your breathing can worsen these effects. Ask your doctor before taking diphenhydramine with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.
Increased Feelings Of Anxiety Or Depression
Anxiety and depression have been linked to Parkinson’s. In addition to movement problems, the disease can also have an impact on your mental health. It’s possible that changes in your emotional well-being can be a sign of changing physical health as well.
If you are more anxious than usual, have lost interest in things, or feel a sense of hopelessness, talk to your doctor.
Going Cold Turkey With Carbidopa/levidopa
Going cold turkey with carbidopa/levidopaVery DangerousParkins1964
ashleyk
Last edited by lurkingforacure; 08-12-2018 at 01:12 PM.Reason: more to say
Medication Not Working The Way It Used To
In the early stages, taking medicine works well to get rid of symptoms. But as Parkinson’s progresses, your medication works for shorter periods of time, and symptoms return more easily. Your doctor will need to change your prescription.
Dr. Valerie Rundle-Gonzalez, a Texas-based neurologist, says to pay attention to how long your medicine takes to kick in and when it stops working. She says you should feel like symptoms significantly improve or are almost gone while on medication.
Parkinsons Disease Medications To Avoid
Doctors avoid prescribing certain medications to Parkinson’s disease patients for various reasons. Before deciding on a treatment plan, your doctor will assess your general health and consider any allergies or intolerances you might have. He or she will judge the best course of treatment based on your age, health status, medical history and existing medications. However, there are some drugs which most doctors will avoid. These include:
- Trihexyphenidyl and benztropine
People with Parkinson’s disease have lower levels of dopamine. This is the chemical that, among other things, controls movement through electrical signals in the brain. Most medications, therefore, work to increase the levels of dopamine in the brain or mimic its effects so that patients experience fewer symptoms.
Unlike dopamine agonists, trihexyphenidyl and benztropine work by restoring the balance of dopamine and acetylcholine in the brain, which can be helpful for controlling tremors and involuntary movements. However, the long-term side-effects of these medications can be severe, particularly in older patients. Doctors rarely prescribe trihexyphenidyl and benztropine today, so these are Parkinson’s disease medications to avoid.
- Some cold remedies, such as decongestants
Some over-the-counter cold and flu medications can interact with Parkinson’s disease medications. You should always check with your doctor or pharmacist about which OTC medications are safe to use.
- Anti-nausea medications
- Chlorpromazine