Medication is only one of many treatments for nonmotor symptoms. Other treatments effective for these problems can be found on the blog.
Acetylcholinesterase inhibitors increase levels of the memory chemical acetylcholine. These medicines can improve cognition, apathy and hallucinations. Examples include:
- Rivastigmine (Exelon)
- Donepezil (Aricept)
NMDA Blockers reduce the effects of the neurochemical glutamate.
- Memantin (Namenda)
Hallucinations can be caused by Parkinson's motor symptoms. Most anti-psychotics can worsen PD motor symptoms since they block the effect of dopamine and should not be used. The following antipsychotics can be used to treat hallucinations:
- Quetiapine (Seroquel)
- Clozapine (Clozaril)
Multiple anti-depressants exist. Below are examples including other problem they can treat.
- Selective Serotonin Reuptake Inhibitors: Can help when anxiety co-exists with depression. Examples include
- Mirtazapine (Remeron)- Side effect of sedation can help insomnia
- Buproprion (Wellbutrin)- Unlike other antidepressants does not worsen restless leg syndrome
- Norepinephrine and Serotonin Reuptake Inhibitors (NSRI). Helpful when pain or fibromyalgia coexists with depression
- Tricyclic and Tetracyclic Antidepressants: Older medicines sometimes used for insomnia and pain but with greater risk of side effects. Examples include
Psuedo Bulbar Palsy
Emotional lability such as frequent crying outbursts often uncontrollable and not associated with depression. Medications that can help include:
- Neudextra (dextromethorphine and quinidine)
Overactive bladder can be treated with anticholinergic medcines that work to reduce bladder muscle spasm. Examples include:
- Oxybuytnin (Ditropan)
- Tolterodine (Detrol)
- Solifenacin (Vesicare)
Lightheadedness and hypotension
These medicines work by increasing blood pressure
- Fludrocortisone (Florinef)
- Proamatine (Midodrine)
Carbidopa (Lodosyn) can help the nausea caused by levodopa (Sinemet).
Antinausea medicines that can help PD nausea include
- Odansetron (Zofran)
- Trimethobenzamide (Tigan)
Some antinausea medinces can worsen PD motyor symptoms and should not be used. Examples include:
- Metoclopramide (Reglan)
- Promethazine (Phenergan)
- Prochlorperazine (Compazine)
Keep track of your medicines.You can download and print a medication log sheet and other helpful workshheets at My Medical Chart.
Monique L. Giroux, MD
Guest Blogger, Former Medical Director of NWPF