|
Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Sleeping from Parkinson's MedicationsForum: Neurology Forum
| ||||
My father has had Parkinson's Disease for over 20 years. Over the last few years he has gotten to where he sleeps about 22 hours a day. He wakes up only to eat, and then goes back to sleep. He sleeps so much that he cannot walk alone any longer and to walk he needs assistance from two people. He has had many different tests and everything is fine. If he does not take his medication, he stays awake, but he needs the medication for movement. He was taking Sinemet, but it quit working, so now he is taking 3 mg of Requip, three times daily and 10 mg of Aricept at bedtime. We cannot get physical therapy for him to learn to walk again, since he sleeps constantly. We have had him to several doctors, but no one seems to know what to do, so he can stay awake and still function. Do you have any suggestions? = Drowsiness is an uncommon, but important, side effect of Sinemet. However, it is usually not so simple as that. Many patients who have significant sleep/wake cycle disturbance (too much or too little or reversed cycle) often have some degree of cognitive impairment to go along with their motor symptoms of Parkinson's disease. Your father clearly has advanced parkinsonism, and is quite complex. There may or may not be anything which can be done. We routinely "tune up" motor function in patients with advanced parkinsonism by using dopamine agonists such as Requip and Mirapex, and the new Sinemet extender (COMT inhibitor) Tasmar. However, these all have cognitive side effects, and if your dad is taking Aricept I would bet he already has some cognitive impairment, putting him at risk for hallucinations, etc. Nevertheless, it is possible that making various changes to his medications could help. If you are not already in the care of a Parkinson's disease specialist, you may wish to arrange for a consultation at Cleveland Clinic. Call 800 223-2273 and ask for neurology appointments (4-5559). Good luck. CCF MD mdf.
|
| |||