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Dr. Andrew Rynne

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Suggest treatment for parkinson disease

Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3614 Questions

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Posted on Tue, 2 Sep 2014 in Brain and Spine
Question: husband has parkinson with lewie bodies medicine==carb/levo 25/100 wears off real fast takes 1/and 1/2 pills
4 times a day every 4 hours 6 am till 6 pm
XXXXXX
doctor
Answered by Dr. Shafi Ullah Khan 2 hours later
Brief Answer:
Needs management

Detailed Answer:
Thank you for asking
Parkinson disease (PD) is one of the most common neurologic disorders, affecting approximately 1% of individuals older than 60 years and causing progressive disability that can be slowed, but not halted, by treatment. Lewy bodies add the severity and make the dementia also kick in.
Here is a complete management plan.
The goal of medical management of Parkinson disease is to provide control of signs and symptoms for as long as possible while minimizing adverse effects.

Symptomatic drug therapy

Usually provides good control of motor signs of Parkinson disease for 4-6 years
Levodopa/carbidopa: The gold standard of symptomatic treatment
Monoamine oxidase (MAO)–B inhibitors: Can be considered for initial treatment of early disease
Other dopamine agonists (eg, ropinirole, pramipexole): Monotherapy in early disease and adjunctive therapy in moderate to advanced disease
Anticholinergic agents (eg, trihexyphenidyl, benztropine): Second-line drugs for tremor only
Treatment for nonmotor symptoms

Sildenafil citrate (Viagra): For erectile dysfunction
Polyethylene glycol: For constipation
Modafinil: For excessive daytime somnolence
Methylphenidate: For fatigue (potential for abuse and addiction)
Deep brain stimulation

Surgical procedure of choice for Parkinson disease
Does not involve destruction of brain tissue
Reversible
Can be adjusted as the disease progresses or adverse events occur
Bilateral procedures can be performed without a significant increase in adverse events
DIscuss the following recent advancements in parkinsons management with your neurologist and see if it helps.
Putative Neuroprotective Therapy
Deep Brain Stimulation
Neuroablative Lesion Surgeries
Preoperative Evaluation
Neural Transplantation
Gene Therapy
Management of Psychiatric Comorbidities
Exercise and Physical Therapy
Speech Therapy

I hope it helps. Take good care of yourself and your husband and dont forget to close the discussion please.
may the odds be ever in your favour.
Regards
Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shafi Ullah Khan 14 hours later
i have noticed that in mornings when first gets up eyes are more clear and is more alert and not shaking so this after not having had any medication for 12 hrs. seem to get worse more medecine he takes as day goes on shakes = tonttgue and mouth shake gets more confused = says his feet have to walk, some times i wander about if carb/levo is good or what
doctor
Answered by Dr. Shafi Ullah Khan 34 minutes later
Brief Answer:
Classic for parkinsons,tolerance increase withtime

Detailed Answer:
Thank you for getting back

There is no doubt the medicines has its own adverse effects and parkinsons worsen and progresses with the passage of time. Compliance to the medications is an issue with the passage of time and dose readjustment is necessary with the passage of time. I mentioned many alternative options which needs to be addressed and consulted with the neurologist.

Morning in good shaped gradually worsening with the passage of time is very common of parkinsons and that needs a complete management plan.

Take care. Dont forget to close the discussion please.

Regards

Khan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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