Side Effects of Parkinson’s Medicines

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

A few of the medicines that are prescribed to Parkinson's patients are known to have some adverse side effects. In this post, we will discuss the path of drugs that physicians commonly use, and which side effects usually accompany them.

Levodopa

This is the most commonly used medication for Parkinson's Disease. In the early days of starting this medication, some patients with Parkinson's Disease feel nausea, but the good news is that many of them get over this as their body adjusts to the medicine.

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

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.

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Other known side effects are:

• ​​Confusion

• Mood swings

• dyskinesia (involuntary body movements)

• 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.

To read more about such side effects, click here.

Dopamine Agonists

As PD results in reduced dopamine production 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 the dosage increased gradually with monitoring of the effects on the patients with Parkinson's Disease.

These medicines are taken once a day (as an extended-release version) or several times daily. 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, regular monitoring and CT scan/ultrasound of the lung and heart is also undertaken.

Amantadine

credit: iStock (Ekatarina Grebeshkova)

This medicine is effective for some patients, and its effectiveness may also be limited to a period. It can have a stimulating effect and thus help some people by reducing tiredness. In some cases, it also helps reduce stiffness.

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

Click to read more.

Interactions with other medications

Some patients with Parkinson's Disease may be taking medicines for other conditions like hypertension or cardiovascular diseases. It is essential to let the physician know of all your medications and changes to them, as some Parkinson's Disease medicines may interact with them and produce undesirable effects. Various Parkinson's Disease 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 a long time. This is called wearing off. In this case, the 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 they go away as soon as the dose is adjusted.

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 medicines with stringent timings (some to be taken before meals, some after meals, 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 indicate which medicine is responsible for those symptoms.

   

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 a 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. 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 patients with Parkinson's Disease, such as hallucinations or compulsive behaviour, may not be aware that they are having them.

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.