Treatment can be complex and should be managed by those experienced in treating both Parkinson’s and cognitive problems. Various trained professionals in the multidisciplinary team might be involved in helping with memory and other cognitive difficulties, or perhaps in reassuring you that the problems are not serious and do not indicate the onset of dementia. These professionals may include your doctor, a Parkinson’s Disease Nurse Specialist (depending on the country in which you live), a neurologist or a psychiatrist for example.
There are also many organisations and support groups that offer various kinds of help. Your doctor or a social worker will be able to help you identify such organisations, or you may find contact details in a telephone directory or using an online local directory.
Medication
At present, there is no medication licensed to specifically treat mild memory problems. Medication used in the treatment of Alzheimer’s disease has not so far been shown to be effective for cognitive difficulties in people with Parkinson’s.
In some cases, adjusting anti-Parkinsonian medications, for example levodopa, can improve symptoms. This could mean, however, that symptoms such as tremor and rigidity are less well controlled. A trial and error approach, balancing out the pros and cons, is often the best way to proceed. Be aware, though, that in many cases adjusting medication may have little or no benefit.
From what is known about medicines and their effects on cognitive problems, the following might be helpful:
- antidepressant drugs sometimes help with the lack of motivation or apathy that can occur in Parkinson's, and they can also improve depression that sometimes accompanies memory problems. See also Depression and Medication
- medication that improves attention and reduces daytime sleepiness may also be helpful - these generally boost energy levels and interest which can improve quality of life, although they will not work if the cause is biological
- anticholinergic medications may worsen cognitive problems and should be discontinued
- hallucinations may improve by reducing or withdrawing some medications (whilst hallucinations are worrying for the carer, often the person experiencing them is not concerned so if treatment for them worsens other symptoms, they may be best left untreated).
