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Side Effects of Parkinson’s Medicines

Updated: Jan 26

(Read in Hindi) Parkinson’s Disease results in many symptoms <link to symptoms article>, some in early stages, which continue to get severe, and some develop as the disease progresses. Though, there is no cure to PD, there are many medications that are prescribed to reduce severity of the symptoms. Taking these medicines are essential to the quality of life of the PwPD as it allows them to carry on with their routine life as long as possible, and give them relief from pain and other disturbing symptoms.




Some of the medicines are known to create some side effects. This post talks about the same related information. We are going to follow the path of medicines that are commonly used by physicians, and accompanying them are narrated their commonly known side-effects.


Levodopa


This is the most commonly used medication for PD.

In the early days of starting this medication, some PwPD feel nausea, but good news is that - many of them get over this the as body adjusts to the medicine.

As Levodopa is absorbed through the gut, constipation or other stomach related problems occur for some.

After taking Levodopa for a long time, some people may have increased involuntary movements, in which case the dosage would have to be adjusted by the physician.


Other known side effects are:

​​Confusion

Mood swings

Sleepiness, fainting or dizziness

Hallucinations and delusions

Impulsive and compulsive behaviour

Side effects of levodopa can sometimes be improved by changing your dose, the form of the drug or how often you take it. It may also be combined with other types of drugs.


Dopamine Agonists


As PD results in reduced production of dopamine in the brain, this is a commonly used medicine to act like dopamine and stimulate the nerve cells to use dopamine more effectively. This treatment has to be started carefully and dosage increased gradually with monitoring of the effects on the PwPD.


These medicines are taken once a day (as extended release version) or several times a day. There are also skin patch versions available.


The side effects are the same as those listed for Levodopa.


In addition, over time, this medicine may affect the lung and heart tissue. So, a regular monitoring and CT scan / ultrasound of lung and heart is also undertaken.



Amantadine


This medicine is effective for some patients and effectiveness too may be for a limited period of time. It can have a stimulating effect and thus help some people by reducing tiredness. Some people benefit by reducing stiffness.


Its side effects could be blurred vision, dizziness and / or swelling of the ankles.



Interactions with other medications


Some PwPD may be taking medicines for other conditions like hypertension or cardio-vascular diseases. It is important to let the physician know of all your medications and changes to them - as some of the PD medicines may interact with them and produce undesirable effects. Variety of PD medicines may also interact adversely with each other, in which case some may be stopped or doses adjusted.


Wearing Off effect


Some PD medicines do not seem to show that much effectiveness after taking them for long. This is called wearing off. In this case, dose has to be adjusted.

In fact, after some time they may start to give effects that look like PD symptoms, e.g. motor fluctuations and others. They can get mistaken for symptoms, but as soon as the dose is adjusted, they go away.


Suggestions for managing side-effects and interactions of PD medicine


  1. The easiest sounding measure is - taking medicine on time, every time. However with a host of prescribed medicine with stringent timings (some to be taken before meal, some after meal and other requirements), it may be a good idea to use mobile or vibrating watches, timed pill boxes to help.

  2. Keep a diary of your symptoms, including times of day that you may feel them - as this would give an indication of which medicine is giving those.

  3. Keep a written note of medication timings. This will help you and any caregiver. Also, it will come in handy for the staff if you are getting admitted to a hospital for some procedure.

  4. Not all side effects that the specialists make you aware of - happen to everyone. So, relax and do not overthink, it may not happen to you or it may be too mild.

  5. Do not stop taking any medicines suddenly, or change dosage yourself - if you experience the side effects. Do consult your specialist and they will change the dosage or try another form to reduce the side effects. Withdrawal from PD drugs is done usually in a tapered way, as one may get withdrawal symptoms otherwise.

  6. If you are a caregiver, note that some side effects experienced by the PwPD like hallucinations or compulsive behaviour - they may not be aware that they are having it.

  7. If you know this, your approach to them may change and you may feel less stressed. Nonetheless, do take care of yourself while caring for the loved one.



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