NetWellness Parkinson's Disease

Stalevo and Artane

Punit Agrawal DO — Fri, 09 Dec 2011 16:12:00 EST

Question: what are the advantages, if any, of taking artane 2 mg three times a day with stalevo in doses of 50/100/200 twice a day and 100/200/200 once a day?

Answer: Everyone with Parkinson's disease requires a different drug treatment regime tailored to his/her symptoms. The use of two different doses of Stalevo is a strategy used to lessen the total daily amount of levodopa and related possible side effects. The Artane is often used as adjunctive therapy to fu . . .

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Namenda

Punit Agrawal DO — Fri, 14 Oct 2011 20:10:00 EST

Question: My dad has parkinson`s and has trouble keeping his balance. He told the doctor and he put him on namenda. When i looked up namenda it mainly said it was for dementia` My dad does not have dementia. He is sharp as a whip. Is namenda sometimes prescribed for balance and avoiding falls? Thank you very . . .

Answer: Memantine (Namenda) is sometimes tried for individuals with Parkinson's disease when there are features of cognitive problems.

It is not uncommon for some of the changes in cognition to lead to an increase in falls, and a trial of this medication may help lessen the fallling.
Ask an Expert: Punit Agrawal DO, Parkinson's Disease

Tardive Dyskinesia with Dystonic Features

Punit Agrawal DO — Wed, 05 Oct 2011 14:10:00 EST

Question: I was diagnosed with tardive dyskinesia; I was weaned off of the medication that started it, I know take Baclofen 20 mg.x 4 for the ability to not have contractures of the hands and feet, and at a movement disorder clinic and a local though I do not think it has an effect on any of the symptoms . . .

Answer: This question is beyond the scope of this forum for Parkinson's disease. Tardive dyskinesia and Parkinson's disease are not the same disorder.

Primary treatment for tardive dyskinesia is stopping the medication that caused it, and commonly there may be some worsening initially after stop . . .

Ask an Expert: Punit Agrawal DO, Parkinson's Disease

Tardive Dyskinesia and Parkinson`s Disease

Punit Agrawal DO — Wed, 28 Sep 2011 17:09:00 EST

Question: I have been diagnosed with tardive dyskinesia, however referred always to movement disorder clinics that specialize in Parkinson Disease. I was on temporarily antispcyhotics for sleep, Reglan, Levsin, other monomini inhibitors, once had a "dystonic reaction", what is the difference between . . .

Answer: Parkinson's disease is a progressive condition that is characterized by loss of brain cells that produce a chemical dopamine. With this loss, a person can have symptoms of tremor, slowness of movement and stiffness (rigidity).

Medication treatment for Parkinson's disease focuses on incre . . .

Ask an Expert: Punit Agrawal DO, Parkinson's Disease

Physical Therapy for Walking with Parkinson`s

Punit Agrawal DO — Wed, 24 Aug 2011 18:08:00 EST

Question: My husband has had Parkinson`s for 11 years and in the past year has had trouble walking. Would he benefit from physical therapy or is there nothing that can be done?

Answer: Physical therapy focusing on walking, balance and also fall prevention can be helpful for individuals with Parkinson's disease. In addition, there are some therapists certified in a specific technique call BIG therapy which is another option.

Ask an Expert: Punit Agrawal DO, Parkinson's Disease

Stop Sinemet Intake Suddenly ...

Punit Agrawal DO — Thu, 16 Jun 2011 21:06:00 EST

Question: Hi sir ...

my grandfather was diagnosed with "vascular parkinsonism" and the doctor prescribed "sinemet" , "parkicapone" and "tonus " as main drugs for him ... the case improved by time ...however due to side effects of drugs my grandfather stopped taking . . .

Answer: Vascular parkinsonism is caused by stroke or other damage to brain due to disease of the brain's blood vessels. This is not the same as Parkinson's disease, though it can mimic some of the symptoms. Vascular parkinsonism is characterized by "step wise" worsening and has rapid worsening due to anothe . . .

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Looking for Dr. w/ Knowledge get off Sinemet

Punit Agrawal DO — Wed, 01 Jun 2011 15:06:00 EST

Question:

I previously asked about DOCTORS known to be knowledgeable on getting people off sinemet. I did not ask for medical advice nor would i accept advice offered on line. Please read my question. Are there any DOCTORS with specific knowledge in getting people without PD off sine . . .

Answer: A carbidopa/levodopa weaning schedule is different for everyone. To avoid an adverse reaction, it is often necessary to do this very slowly. Most neurologists can assist in providing a proper schedule that would be right for you.

Ask an Expert: Punit Agrawal DO, Parkinson's Disease

Central Spinal Cord Damage and DBS

Punit Agrawal DO — Sat, 02 Apr 2011 01:04:00 EST

Question: I fell and had central spinal cord damage, will this prevent me from having dbs surgery.

Answer: With DBS therapy, it will not be possible to have MRI of the spine. The spinal cord damage may need to be addressed prior to having DBS surgery. Your current health care providers can help you determine if anything needs to be done prior to pursing DBS surgery. If not already done, you also would . . .

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Doubts about Diagnosis

Punit Agrawal DO — Fri, 01 Apr 2011 04:04:00 EST

Question: I was diagnosed with Parkinson`s seven and a half years ago. I am affected on my right side only and my symptoms are still quite mild. I am on 300 mg stalevo, 18 mg slow release requip and azilect daily. My symptoms when medications are very near to wearing off are tremor in arm, dragging leg sli . . .

Answer: For people with milder disease or great response to medications, they may not notice much progression of motor symptoms due to medications continuing to help. However, non-motor symptoms such as trouble with urination, constipation, and many other things could slowly develop with time. These non-m . . .

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Treatment of Hallucinations

Punit Agrawal DO — Fri, 25 Feb 2011 18:02:00 EST

Question: My husband was diagnosed with PD 5 yr. ago. He takes Sinemet 25/100 2 X a day. In the last 6 mo. he has developed severe hallucinations in which he sees other people which replace me. Seroquel (25mg) was prescribed. It helps with sleeping but not the problem. The dose was doubled which caused more d . . .

Answer: The development of psychosis and cognitive trouble in parkinsonian syndromes can be challenging. It is often necessary to have a medical evaluation to assess if there are medications worsening these issues and also to assess if there are other contributing medical problems as well.

. . .

Ask an Expert: Punit Agrawal DO, Parkinson's Disease