An abrupt change in PD symptoms may be caused by a problem other than PD. Treatment therefore may require a different approach then simply changing Parkinson’s medicines.
In general, Parkinson’s disease is a slowly changing condition, yet you may find that your symptoms change dramatically overnight. If your movement, thinking or cognitive function change dramatically and quickly it may be due to something other than a change in your Parkinson’s disease. The following information helps you and your health care provider find other causes for your recent change:
• A recent addition of Parkinson’s medicine or dose increase can cause confusion.
• Fall with head injury can worsen neurological function.
• Other medicines such as some medicines for Parkinson’s, sleep, emotions, bladder control, pain or muscle spasm can cause confusion.
• Stress. This can include may types of stress- emotional stress, physical stress (including physical pain), medical stress (such as a recent operation and recovery) and even lack of sleep.
• Medical problem. The added stress of another medical condition can significantly worsen Parkinson’s symptoms. Examples include:
- Bladder infection
- Heart or breathing problems
- Sleep apnea
- Other infection
These problems can be treatable and symptom change reversible. Talk to your provider to determine if more testing is needed if you have experienced a rapid change in symptoms.
Othello syndrome describes a form of psychosis in which one has delusional thoughts about their partner having an affair or similar relationship that does not exist. They may misinterpret ‘clues’ to support this delusion.
Delusions and hallucinations can be seen with certain psychiatric disorders and in the setting of Parkinson’s disease with the following conditions:
-High dose dopamine medicines especially dopamine agonists, amantadine and selegiline
-Other medicines that can cause confusion such as anticholinergics, muscle relaxants and pain medicines (narcotics)
-Illicit (street) drugs)Cognitive problems suggestive of dementia
-Coexisting medical conditions such as thyroid disease, vitamin deficiency (B12),infection or dehydration
-Reducing medicines when possible
-Occupational therapy evaluation to analyze how someone is taking medicines and help family administer medicines in the event the person with PD is taking more than prescribed
-Antipsychotic medicines- namely clozaril or quetiapine
-Cognitive enhancing medicines such as rivastigmine
-Counseling and psychiatric evaluation to evaluate for other conditions
-There is little evidence to date about the effect of a new antipsychotic.
-A combined neurology and psychiatry evaluation may be needed for this difficult problem.
See related article on hallucinations
November is national caregiver month and a fitting time to show gratitude toward the carepartner or caregiver in our live. Being a caregiver to a person with Parkinson’s has its share of challenges and it share of rewards. For some caregivers the increased stress can increase their risk of depression and cause additional illness. Show your caregiver that you appreciate them during National Caregiver month.
- Encouraged your partner to have their own free time to pursue personal interests, hobbies and passion.
- Join a support group, include your partner and connect with others
- Communicate. Don’t forget to talk about things both good and bad.
- Organize, downsize and simplify. This might be a time to take inventory of that which complicates life, adds unnecessary work or more stress to life and get rid of it.
- Do what you can and ask for help when you need it.
- Be positive.
- Find enjoyment in life and remember to laugh.
- Be realistic. There are 24 hours in a day not 48.
- Continue your outside interests, passion or hobbies.
- Find things you both enjoy-dancing, movies, restaurants, a casual walk in nature
- Surprise your caregiver with a token of appreciation -Chocolate is a good start!
Reply to this posting and support the caregiver in your live and others by adding your own ideas to this list. to this list.
Are there programs that help people get and afford their medications?
I have found these resources for people who need to purchase medications but do not have the resources. Some drug companies will help people without medication coverage and some will also help people who have medicare Part D if they are low income. You can contact the pharmaceutical company online by searching the name of your drug on the web and contacting their patient assistance program. Check out these additional resources:
Non profit information resource on programs that may be able to offer help to patients. www.needymeds.org
Provided by Medicare to help those with limited resources and income pay for monthly premiums, annual deductibles and prescription co payments related to a medicare prescription drug plan www.ssa.gov/prescriptionhelp
Broad database of patient-assistance programs. It is part of the Center for Primary Care and Prevention at Memorial Hospital of Rhode Island www.rxassist.org
Non Profit that offers prescription medicines to uninsured individuals and families, as well as those who have limited prescription drug coverage www.rxoutreach.org
Each plan needs an application and your doctor will have to fill it out as well.
See NWPF Wellness Center for more resources on the web. Learn more
Ruth Egger, MA , NWPF Program Director