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Parkinson's Disease

Medications - PWP

12/05/2000

Question:

My mom is 73. Diagnosed with PD at age 70. Was put on sinemet by neurologist. Claims med gave her heart palpitations. Taken off med by gp. Has not taken any Parkinsons med since. Had a bad fall beg. Sept. Now ready to try meds again. Believe heart problem due to anxiety. Had a nervous breakdown in 1960,(very nervous, gets upset over EVERYTHING)Taking 1/2 paxil/day, 1 aspirin/day right now. What would the best med be to start her on right now?She still lives alone. Has homecare 3 xweek for 5 hrs. per week.Any info would be appreciated.

Answer:

It is difficult to give a specific answer without the benefit of an examination. However, in general in older patients with cognitive problems I usually prefer Sinemet to dopamine agonists like Mirapex, Requip or Permax as there seems to be a lower incidence of cognitive side effects.

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Response by:

Arif Dalvi, MD
Assistant Professor
College of Medicine
University of Cincinnati