Parkinson’s & medication
Introduction
Medication is almost always the main treatment for Parkinson’s disease It cannot cure the condition but it can usually provide good symptom control for some time.
Our movements are regulated by chemicals in the brain called neurotransmitters. In Parkinson’s, levels of the neurotransmitter dopamine are depleted as the nerve cells which produce it are gradually lost. This means that the signals the brain sends to our muscles become interrupted and movement is disturbed. A wide range of medications have been developed either to replace dopamine or to mimic its effects.
Every case of Parkinson’s is unique and symptoms are different for everyone. They can vary from day-to-day, hour-to-hour, even minute-to-minute and your own individual patterns will determine what medications you are prescribed.
When you start taking medication
You will need to work closely with your doctor in finding the right balance, combination and dosage of medications that will suit you. Together, you will be able to monitor your response to the treatment so that any changes or adjustments can be made if necessary. It is also important to tell your doctor about any change in symptoms or side effects you experience. Both of you will discuss the times of day you should take the medication so that it works best for you. You should however keep to the overall daily dose prescribed and follow any instructions you are given.
For further information on monitoring your response to medication and its timing, see Keeping a Diary.
The role of the pharmacist
A pharmacist is qualified to prepare and dispense drugs, and to offer advice on your prescribed medications. If you have any queries or are concerned about possible side effects of your medication your pharmacist should be able to help. However, as getting the balance of Parkinson’s medications for each individual right is complicated, they will not generally be involved in adjusting or altering your medication – this is something for your doctor to take care of and monitor on an on-going basis.
Interaction with other medications and contraindications
Many people with Parkinson’s take other medications to treat various unrelated conditions. Because some medications can interact with others, it is always a good idea to tell your doctor or health professional about any other medicines, remedies or supplements you are taking, including over the counter medications that have been bought without a prescription.
Some medications may have harmful interactions with others – known as contraindications – and can either worsen your existing symptoms or bring on Parkinson’s-type symptoms that will disappear if you stop taking that medication. If you have any concerns or are apprehensive in any way about your medication please discuss this with your doctor, health professional or pharmacist as soon as you can. They will be able to advise you and put your mind at rest.
Side effects
Side effects are many and varied - including hallucinations, nausea, vomiting, diarrhoea and delirium - and differ widely from one medication to another. Everybody reacts to medication differently and it is always important to read the information leaflet provided outlining the possible side effects. If you experience side effects or have any concerns, you should discuss these with your doctor, health professional or pharmacist as soon as possible so that they can review or change the medication if necessary.
If you forget to take your medication
It is important to discuss with your doctor what would happen if you forget to take your medication so that you are prepared and understand what action you should take if this situation arises.
If you forget to take your medication you may notice a worsening of your symptoms, often known as ‘wearing off’, as the effects of the medication literally wear off. Symptoms may then either re-emerge or worsen before the next dose of medication is due. This tends to happen more as Parkinson’s progresses, and when it occurs there is a fluctuation in control of both motor and non-motor symptoms. This phenomenon is very individual and varies from person-to-person and, as such, there is no standard time frame for when this may occur or what symptoms you might experience.
The range of wearing-off symptoms is very broad so any changes in your usual pattern should be discussed with your doctor. Changes may indicate that you are experiencing wearing-off, in which case your doctor might adjust your medication regime to help control symptoms better.
For further information see http://www.epda.eu.com/pdfs/patientInformationLeaflets/leaflet04.pdf and http://www.epda.eu.com/wearingoffquestioncard.shtm
