On August 20th the New Mexico Parkinson’s Coalition sponsored a very informative workshop for Parkinson’s patients and caregivers, hosted by the Highland Senior Center in Albuquerque. The two pharmacists who shared their time and expertise were Emily Reynolds and Doreen Rosenberg. Ms. Rosenberg has personal experience with Parkinson’s herself as well as her experience as a pharmacist at UNM Hospital for the past 10 years.
In Parkinson’s Disease, the goal of medications is to normalize imbalances in the brain. There is an imbalance between dopamine and acetylcholine. In most cases there is a higher level of acetylcholine; when it is brought back into balance it improves symptoms such as shakiness, stiffness and slow movement.
Reynolds and Rosenberg helped attendees to understand the general types of medication for Parkinson’s Disease (PD). They also discussed techniques for taking PD medications for maximum beneficial effect.
The most common PD med is Levodopa, which provides a source of dopamine to the body. It works especially well to treat slow movement, and can help improve stiffness and shakiness. One of the tips offered to taking Levodopa for people new to the medication is that they may have less nausea as a side effect if the take it with food. Conversely, people with more advanced PD may find more improvement in motor symptoms if the take it on an empty stomach.
Another family of medications that helped activate dopamine receptors in the brain are “helpers” called Dopamine Agonists. There are several available and can be used alone or in combination with other medications. Two of these meds, Ropinirole and Pramipexole, are also used for restless leg syndrome, which is often a precursor of PD. The most disconcerting possible side effect is that these medications have been associated with an increased risk of impulse control disorders (gambling, sexual behavior, shopping).
The lesson here is that there are many choices when it comes to selecting a medication that will benefit a patient with a minimum number of side effects. We recommend that all involved doctors are consulted before new medications are taken.
Medications can certainly benefit — but they can have many downsides. Make sure that yours are not a minefield.