Dr. Sydney Piercey
650 SW 3rd Street, Corvallis OR 97333-4437
Phone: 541-207-3900, Fax: 541-207-3232
http://www.pierceyneurology.com
Parkinson’s 10 Tricks and Tips in Addition to Treatment
1. Make the most of that morning dose
Many people with Parkinson's disease find that their ability to move around freely is worst in the
morning. Try setting tomorrow morning's first dose on the nightstand along with a glass of water.
You may even set the alarm clock for an hour before you plan to awaken so you can take the dose and
then roll over for another hour of sleep.
2. With food or without…that is the question. Pay attention to whether you take your pills with food.
When you take your medication on an empty stomach, more of it is absorbed into
your bloodstream.
On the other hand, if your medication makes you queasy or nauseated, then you can minimize this by
taking it at mealtime. Just avoid high protein meals. Protein binds the Sinemet.
3. Avoid most anti-nausea medications.
Most anti-nausea medications can worsen the symptoms of Parkinson's disease or
interfere with the benefits of Parkinson medication by blocking the brain’s dopamine receptors. The
dopamine receptors are the very receptors that most Parkinson medications seek to activate. Taking
anti-nausea drugs while also taking Parkinson medications means that you're taking a drug and its
antidote at the same time. They cancel each other out or quite possibly the anti-nausea medication may
make your Parkinson symptoms markedly worse.
Some of the most common anti-nausea drugs are:
Metoclopramide (Reglan),
Promethazine (Phenergan) and
Prochlorperazine (Compazine)
However, one anti-nausea drug, ondansetron (Zofran), works on a different chemical receptor and
avoids this problem.
Remember: For Nausea, Zofran is good and almost everything else is bad, BAD, BAD.
4. Be mindful of forgetfulness.
People with Parkinson's disease may already be more prone to forgetfulness because of
either their disease or their age. But certain medications maybe making this worse. Sometimes it is
simply impossible to avoid one of these medications but make sure you talk with your doctor spefically
about the medication and the fact you have Parkinson's disease and you don’t want your symptoms to
be worse.
 benztropine (Cogentin) and trihexyphenidyl (Artane): These are old medications and rarely used.
 For urinary incontinence: tolterodine (Detrol) and oxybutynin (Ditropan), can worsen memory.
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Dr. Sydney Piercey
650 SW 3rd Street, Corvallis OR 97333-4437
Phone: 541-207-3900, Fax: 541-207-3232
http://www.pierceyneurology.com
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The tricyclic antidepressants: Nortriptyline and amitriptyline can be problematic as well.
Medication that treats abnormal behavior, hallucinations can be especially problematic: Haldol
and Risperdal are is bad, BAD, BAD in patient’s with Parkinson’s disease. Seroquel however can
often be used instead.
5. Know the difference between tremors and dyskinesias.
Dyskinesias: Excessive, involuntary movements that are like dancing, wiggling and fidgeting. This may
indicate you are receiving too much of your Parkinson’s medication or you are becoming sensitive to the
medication.
Parkinson’s tremor: This is the higher amplitude, rhythmic oscillation tremor, of moderate frequency.
Typically affects arms or legs.
6. Swallow your pride and use a walking stick.
As symptoms of Parkinson's disease slowly worsen over the years, imbalance can make
walking less safe and secure. Yet many patients avoid using walking sticks, canes or
walkers. Sometimes they even buy these gait-stabilizing devices, but leave them in the
closet, unused. I hear patients say that they don't like the idea of "giving in" to the disease
by using such devices.
A wounded one's pride is better than a wounded hip because of a fall.
Also people who use canes or walkers tend to walk more not less than people who refuses to use
anything and are completely unstable.
7. Take advantage of useful gizmos.
When loss of motor skills interferes with getting dressed, eating food or taking a bath,
then it's time to make use of devices designed to make these and other activities of daily
living easier. Objects as low-tech as button-hooks, dressing sticks, fat-handled utensils,
large-buttoned telephones, grab bars and shower chairs can make life simpler and
promote independence. You may also try a laser pointer aimed at the ground if you are having difficulty
initiating your first step.
8. Mentally rehearse your next move.
Sometimes getting out of a chair requires multiple attempts. Or, when walking is
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Dr. Sydney Piercey
650 SW 3rd Street, Corvallis OR 97333-4437
Phone: 541-207-3900, Fax: 541-207-3232
http://www.pierceyneurology.com
interrupted by a "freezing attack," an uncomfortably long period of time is required to get
unfrozen and moving again. In these circumstances, the trick is to mentally rehearse the
next move so thoroughly that you can actually picture yourself accomplishing it. Then,
when you actually do try to move, you're more successful.
9. Maintain body weight.
In patients with advanced Parkinson's disease, the mere act of chewing food can require
so much work and effort that dietary intake plummets. If the patient is overweight to start
with, this might be useful to a point, but continued weight loss can threaten health. In such
circumstances, one should take advantage of food supplements that permit intake of
important nutrients with a minimum of effort. This is a good time to indulge one's love of
ice cream and milk shakes, which are packed with protein and calories, and require a
minimum of chewing. Supplementing one's usual diet with a can or two of pre-packaged
products like Ensure or Sustacal adds missing ingredients that prevent weight loss.
Carnation Instant Breakfast provides many of the same ingredients, but at lower cost.
10. Stay flexible by exercising.
You've heard the expression, "Use it or lose it." As a saying, it's trite and overused, but in
Parkinson's disease it is nonetheless true. By exercising the very movements that
Parkinson's disease affects, one can improve them. The emphasis is on flexibility rather
than strength-building. Although pumping iron can be helpful, too, one should focus on
stretching, limbering and range of motion.
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