Finding Balance with Medications

Finding Balance with Medications

What is my strategy?

I plan to take Parkinson’s disease (PD) medications as prescribed to get me to a point where I can function well and really push hard in my exercise. Then, I hope that a combination of exercise, diet, meditation, yoga, and massage will help me to deal with my PD progression and symptoms.

Currently, I take Sinemet (carbidopa-levodopa) 25/100, two tablets, three times per day. With my doctor’s guidance, I am weaning off a daily 4 mg Neupro patch. Sinemet has alleviated my internal tremors. However, I am still extremely fatigued all of the time.

Do I really believe the medications are helping?

I have never had any “aha!” moments as a result of taking medications. It was never like “wow, I feel so much better now.” I don’t experience the “off time” that some have when the meds are wearing off shortly before the next dosage is due. So, I question how much the medications are really helping me.

Why do I want to reduce or halt my PD medications?

Opioids target the brain’s reward system by flooding the circuit with dopamine. In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid-based pain relievers. They were wrong — there is currently an opioid overdose crisis in the U.S.

Although opioids get more media attention, abuse of benzodiazepines (benzos) is equally rampant. Benzos create surges of dopamine in the body. Since their introduction in the 1960s, this class of medications, which includes Valium (diazepam), Ativan (lorazepam), and Xanax (alprazolam), have been widely prescribed to treat anxiety and insomnia, alcohol withdrawal, and other conditions. These medications must be prescribed with caution because they can be addictive.

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Levodopa, a component of Sinemet, may improve PD symptoms because it causes the body to make more dopamine. Neupro (rotigotine) patches work by delivering the dopamine agonist rotigotine through the skin directly into the bloodstream. Rotigotine stimulates dopamine receptors in the brain. This, in turn, mimics the action of dopamine, which is found in lower-than-normal levels in the brains of Parkinson’s disease patients.

My conclusion

From my simplistic, high-level view, I see a common denominator (dopamine) in the three categories of the medications mentioned above. Even though my brain may not be functioning properly due to PD, taking drugs that impact the brain does not sit well with me.

What will be said about PD medications in the future? I am not sure I want to find out. This is why I am choosing to wean off as many of the PD drugs that I can. I want to continue to seek balance and to pursue my more holistic approach to diet and exercise to tame the PD dragon.

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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

8 comments

    • Jean Mellano says:

      Hi Gloria,

      It is getting harder and harder to get the energy to work out. I was a disciplined athlete (cycling, race walking and weight lifting, dancing) prior to being diagnosed with pd. I have to dig so deep now to pull out the energy required to do the exercising I do. But, the fatigue can be crushing and no amount of sleep or rest can help.

  1. Forrest says:

    I am struggling to work full time. I get to work really early to prepare for the day. Mid way through the morning I’ve very little stamina left in the tank. I limp through the afternoon. When I get home I sleep until tea then again till bedtime, then through the night. As the main wage earner, I’m trying my best to stay at work for my family. It’s too tough and I wonder how much longer I can manage.

    • Jean Mellano says:

      Hi Forrest,
      I am so sorry to hear of your plight. I am retired and do not think I could possibly work feeling the way I do. You are so strong to be able to do that. Sometimes it is hard to explain to others the kind of fatigue those of us with PD have. I find no amount of sleep can make me feel better. Hang in there…

  2. Sandi Leon says:

    after reading these articles its making me really sad because as it goes on and seemingly getting worse I’m thinking there is no other thing to do except take more meds to even walk and more drugs to be relieved from the horrible pain in my legs. i go to the gym now 3-5 times a week. but like it said the energy gets me down at times then i have to sleep at least 0-15 minutes then i am good to go. and dementia…this is really scary to me as the forgetting things are already starting to happen. I don’t like what is happening but its quite apparently going to do its thing no matter what i do.

  3. Mary Schroeder says:

    Hi Jean
    Kudos to you for speaking out about two very difficult issues. Mental illness impacts the lives of so many and I send my sympathy for the tragedy you have endured.
    I stumbled into your blog as a result of my use of Neupro, not for PD but for severe RLS. After years of taking Sinemet (both the 25/100 for days and 50/200 for nights) with moderate success, I began using the Neupro Patch. Although the patch provides more reliable relief, I have had to switch from the 3mg patch to the 4, and find it to be very difficult on my skin — and the cost is becoming prohibitive. I am also trying to switch back to the Sinemet but am frustrated by my inability to sleep more than 3-4 hours/night. How do you get through the nights using Sinemet?

    • Jean Mellano says:

      Hi Mary, since that article, I am still trying to find the right combination of Sinemet and Neupro. Currently, I am on (2) 25/100 Sinemet 2x/day and 2mg Neupro patch. Sinemet does not affect my sleep that I know of, but Dr. originally suggested taking Sinemet after lunch and at night. After several days w/o a morning dose od Sinemet (although I put my Neupro patch on first thing at around 7am.), I was so gfoggy and spacey, I started taking my first dose od Sinemet after breakfast and take second dose around 2pm. The larger the patch gets as u go up in mg. becomes cumbersome to apply as there is only so much real estate on the arms and legs to use it LOL. I do take a magnesium capsule before I go to bed and that may or may not be helping me sleep. Since my fatigue is so bad, someone suggested I be tested for sleep apnea which can be a symptom of PD in some. Rgegarding financial assistance for SInemet/NEupro, sometimes the drug manufacturer will provide co pay assist for the first year. Also, check out tafcares.org and panfoundation.org for co pay assist. Good luck and let me know how you make out…

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