HeroTeo - The Parkinson’s Fighter

Posted: Fri Jun 08, 2007 8:52 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

I was refereed by Dr. Kathrynne Holden, to post the following:

As emotional and cognitive disorders are common in Parkinson’s disease, but are frequently overlooked or under treated.

Some PD patients are aware of the emotional disorders and associated with there matrimonial relationship when they come to certain disagreements. As the result they have depressive,delusions and sleep disorders. They usually refer to marriage counselling or psychiatric consultation.

In this connection I have the emotional disorders for the past of 20 years and they are associated with the matrimonial relationship until recently I find out they are byproduct of PD. All efforts going to marriage counselling or psychiatric are frustrating.

I understand there are between 40-60% PD patients have emotional disorders. Sensitivity to certain behaviours,issues and understanding are the causes of bad matrimonial relationship. They are the byproduct of
anxiety,phobias,apathy,hallucinations,delusions and sleep disorders.

Kindly advise me how to address the psychiatric and cognitive side effects of anti-Parkinson medications and surgical treatments.

Thanks

TEOKIMHOE

Back to top

Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Fri Jun 08, 2007 7:43 am Post subject:

——————————————————————————–

Dear Teo,
These are very good questions to raise, because there are many emotional as well as cognitive changes that may occur as PD progresses. Emotional instability, depression, attitudes toward sexuality, all may occur.

However, this is outside my scope of practice as a registered dietitian. This requires the efforts of a neurologist who specializes in PD who can determine whether counseling or medications or a combination of both is the best approach.

I highly recommend you address this question to “Ask the Doctor” — the doctors have wide experience in the many mental and emotional changes occurring in PD.
_________________
Best regards,
Kathrynne Holden, MS, RD
–
For a Parkinson Tip

Okun,

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sat Jun 09, 2007 1:30 am Post subject:

——————————————————————————–

There are high rates of depression, anxiety, apathy and other mood/emotional disorders in PD. PD also causes stress on marriages. The two must BOTH be treated. I suggest SSRI’s, clinical psychiatry, psychology, and marital counseling. I take these problems seriously in my patients and I use the multidisciplinary team.
_________________
Michael S. Okun, M.D.

Back to top

Anonymous

Posted: Sat Jun 09, 2007 5:44 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

I have known PD as an illness of the “body, mind and soul

As for me my psychiatric problems have been normal. I have improved my matrimonial relationship.

I understand emotional disorders are the byproduct of PD and it is more difficult to treat than the movement problem as new discovery made drastic improvement in the treatment of the movement problem in PD. Cognitive disorders are common in PD - anxiety,depression etc

As I have difficult agility’s my doctor increases my medication from one requip 0.25mg to two, three and four doses weekly three times a day.

For antidepression: one fluvoxamine maleate 50mg and Rivotril 0.5mg at night

He will cutdown my sinemet 25/100 and Jumex 5mg as times goes by to optimize the medication. As sinement has sideeffect on me sleepless at night, bad dream, agilities and emotional stress.

Kindly comment

TEOKIMHOE

Back to top

Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Sun Jun 10, 2007 8:19 am Post subject:

——————————————————————————–

I think you asked a similar question on this already that I tried to answer.

Yours,
_________________
Hubert H. Fernandez

Back to top

Anonymous

Posted: Wed Jun 20, 2007 7:59 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,
‘
In view of my articles as the matrimonial relationships are the part causes of emotional disorders. Are they helpful for both parties to avoid their sensitive issues that cause emotional disorders?

What is the part of doctors to maintain the matrimonial relationship? Medication? Counselling?

Do you agree the above is the best way to counter the emotional relationship than the medication?

Why some doctors consider them as matrimonial relationship as they play no part on it as it is their privacy? They are interested to prescribe the antidepression medication? Some doctors even refer it as a psychiatric disorders or psychology

Kindly elaborate

TEOKIMHOE

Back to top

Anonymous

Posted: Wed Jun 20, 2007 8:14 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

One of the reason the cause of emotional disorders in matrimonial relationship both parties do not agree each other on how to value the relationship.As the result their families broke off.

They do not try to avoid and still repeat on doing the sensitive issues that cause the emotional disorders. Each time they ask for forgiveness that aggravates the emotional disorders, anxiety, depression , apathy and delusions of PD patient. Some doctors even are not playing a part on helping instead prescription of antidepression.

Kindly elaborate

TEOKIMHOE

Back to top

Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Wed Jun 20, 2007 3:59 pm Post subject:

——————————————————————————–

Thank you for your comments.
_________________
Michael S. Okun, M.D.

Back to top

Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Wed Jun 20, 2007 4:01 pm Post subject:

——————————————————————————–

We prefer to address these problems in a multidisciplinary fashion. A licensed clinical social worker, marriage counseling, and when necessary pharmacological approaches for mood disorders…

It takes a multiprong and tailored approach as each situation is different.
_________________
Michael S. Okun, M.D.

Back to top

Anonymous

Posted: Sat Jun 23, 2007 1:38 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

In view of the treatment for emotional disorders as suggested by you both PD specialist ,Psychiatrist and psychologist working together.

Do you agree there is a lot of overlapping in the role of PD specialists and psychiatrists working together?

Best regards

TEOKIMHOE

Back to top

Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Sat Jun 23, 2007 9:07 am Post subject:

——————————————————————————–

Yes, I agree. And all disciplines must work together.

Yours,
_________________
Hubert H. Fernandez

Back to top

Tags: General by heroteo
No Comments »

Posted: Wed Jun 20, 2007 6:49 pm Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

There are reasons that cause emotional disorders on PD patients. I am one of the suffers for many years. It is related with my matrimonial relationship. There are certain issues are sensitive to me but not for partner. the emotional disorders causes me depression, anxiety, and sleep disorders.

Some doctors treat it as their privacy and refer to psychiatric or counselling . They prescribe antidpression doses to relieve the disorders as they are not trained in this field.

What are the role of the PD specialist for the emotional disorders is it limited only presciption antidepressions drugs only? They refer the emotional disorders as a psychistric or psychotherapy.

Kindly elaborate the above

TEOKIMHOE
Thanls

TEOKIMHOE

Back to top

Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Wed Jun 20, 2007 8:46 pm Post subject:

——————————————————————————–

It depends on what the comfort level of your PD specialist has. Some do not even prescribe anti-depressants and anti-anxiety agents. They simply refer to a psychiatrist and psychologist.

Others prescribe the medications but do not do psychotherapy, so they refer to psychologist or marriage and family counselor but give the medications.

A few do both pharmaco- and psycho-therapy.

Yours,
_________________
Hubert H. Fernandez

Back to top

Anonymous

Posted: Thu Jun 21, 2007 3:59 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

I am suffering emotional orders for many years. I have consulted marriage counselling and psychiatrist for treatment.
They are not helpful for my sickness as they listen to one side of story as the suffer in in trouble in the matrimonial relatinship with his/her partner.

In this connection I have to thank Dr, Chew Nee Kong of Pantia Cheras Hospital Kuala Lumpur who is the Movement Disorders Specialist who diagnosed my emotional disorders in my matrimonial relationship with my partner i.e without considerate for doing things and hurting me and sensitive issues that I do not accept it . I lost my dignity and respect in the society. Therefore he slowdowns my emotional disorders,

From the above experience some emotional disorders to be cured not by medication but my observation.

Kindly elaborate’

TEOKIMHOE

Back to top

Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Thu Jun 21, 2007 5:31 pm Post subject:

——————————————————————————–

Dear Teo,
I can’t offer any information additional to that given by Dr. Fernandez, unfortunately. Very often, a good and sensitive marriage counselor is the answer; sometimes, antidepressant medication is the best solution. It sounds as though you found the ideal physician in Dr. Chew Nee Kong, and I only wish everyone was as fortunate.
_________________
Best regards,
Kathrynne Holden, MS, RD
–
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/

Back to top

Anonymous

Posted: Thu Jun 21, 2007 5:39 pm Post subject: Exercises and Movement

——————————————————————————–

Dear Doctor,

I believe some emotional disorder disease could be cured especailly the matrimonial relatinship. There are certian issues that causes the breakoff matrimonial relationships i.e. inconsiderate for the partner or senitive issues that the partner could not accept/. I

I am one of the victim of the emotonal disorders that suffer for 20 years I went to pyschiatrist and councelling for treatment and consultaion and am victim that causes the troublde but is not the other partner that makes excuses of what he./she done wrong.

In this connection I have to thank you for Dr.Chew Nee Kong of Pantei cheras Hospital Kuala Lumpur for his counselling. He emphasis that inconsiderate and sensitives issues are the causes of bad matrimonail relationship\

I am pleased with his fair remarks and helping my emotional disorders slowdown as ,my partner admited/

Do your believe emotional disorders do not neccessary taking medication and itis the best to do is considerate for the other whilst doing things or sensitive issues to be avoiddd that the party do not accept .

This is my experience to share wiht the readers’

Kindly comment’

TEOKIMHOE

Back to top

Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Fri Jun 22, 2007 1:31 pm Post subject:

——————————————————————————–

I will post for you, and let the reader take in your comments. As I have previously expressed I use a multidisciplinary approach.
_________________
Michael S. Okun, M.D.

Back to top

Tags: General by heroteo
No Comments »

Posted: Wed Jun 20, 2007 6:49 pm Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

There are reasons that cause emotional disorders on PD patients. I am one of the suffers for many years. It is related with my matrimonial relationship. There are certain issues are sensitive to me but not for partner. the emotional disorders causes me depression, anxiety, and sleep disorders.

Some doctors treat it as their privacy and refer to psychiatric or counselling . They prescribe anti depression doses to relieve the disorders as they are not trained in this field.

What are the role of the PD specialist for the emotional disorders is it limited only prescription anti depressions drugs only? They refer the emotional disorders as a psychiatric or psychotherapy.

Kindly elaborate the above

TEOKIMHOE
Thanls

TEOKIMHOE

Back to top

Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Wed Jun 20, 2007 8:46 pm Post subject:

——————————————————————————–

It depends on what the comfort level of your PD specialist has. Some do not even prescribe anti-depressants and anti-anxiety agents. They simply refer to a psychiatrist and psychologist.

Others prescribe the medications but do not do psychotherapy, so they refer to psychologist or marriage and family counselor but give the medications.

A few do both pharmaco- and psycho-therapy.

Yours,
_________________
Hubert H. Fernandez

Back to top

Anonymous

Posted: Thu Jun 21, 2007 3:59 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

I am suffering emotional orders for many years. I have consulted marriage counselling and psychiatrist for treatment.
They are not helpful for my sickness as they listen to one side of story as the suffer in in trouble in the matrimonial relationship with his/her partner.

In this connection I have to thank Dr, Chew Nee Kong of Pantia Cheras Hospital Kuala Lumpur who is the Movement Disorders Specialist who diagnosed my emotional disorders in my matrimonial relationship with my partner i.e without considerate for doing things and hurting me and sensitive issues that I do not accept it . I lost my dignity and respect in the society. Therefore he slowdowns my emotional disorders,

From the above experience some emotional disorders to be cured not by medication but my observation.

Kindly elaborate’

TEOKIMHOE

Back to top

Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Thu Jun 21, 2007 5:31 pm Post subject:

——————————————————————————–

Dear Teo,
I can’t offer any information additional to that given by Dr. Fernandez, unfortunately. Very often, a good and sensitive marriage counselor is the answer; sometimes, antidepressant medication is the best solution. It sounds as though you found the ideal physician in Dr. Chew Nee Kong, and I only wish everyone was as fortunate.
_________________
Best regards,
Kathrynne Holden, MS, RD
–
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/

Back to top

Anonymous

Posted: Thu Jun 21, 2007 5:39 pm Post subject: Exercises and Movement

——————————————————————————–

Dear Doctor,

I believe some emotional disorder disease could be cured especially the matrimonial relationship. There are certain issues that causes the break off matrimonial relationships i.e. inconsiderate for the partner or sensitive issues that the partner could not accept/. I

I am one of the victim of the emotional disorders that suffer for 20 years I went to psychiatrist and counselling for treatment and consultation and am victim that causes the troubled but is not the other partner that makes excuses of what he./she done wrong.

In this connection I have to thank you for Dr.Chew Nee Kong of Pantei cheras Hospital Kuala Lumpur for his counselling. He emphasis that inconsiderate and sensitives issues are the causes of bad matrimonial relationship\

I am pleased with his fair remarks and helping my emotional disorders slowdown as ,my partner agrees too./

Do your believe emotional disorders do not necessary taking medication and it is the best to do is considerate for the other whilst doing things or sensitive issues to be avoided that the party do not accept .

This is my experience to share with the readers’

Kindly comment’

TEOKIMHOE

Back to top

Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Fri Jun 22, 2007 1:31 pm Post subject:

——————————————————————————–

I will post for you, and let the reader take in your comments. As I have previously expressed I use a multidisciplinary approach.
_________________
Michael S. Okun, M.D.

Back to top

Tags: General by heroteo
No Comments »

Dear Doctor,
‘
In view of my articles as the matrimonial relationships are the part causes of emotional disorders. Are they helpful for both parties to avoid their sensitive issues that cause emotional disorders?

What is the part of doctors to maintain the matrimonial relationship? Medication? Counselling?

Do you agree the above is the best way to counter the emotional relationship than the medication?

Why some doctors consider them as matrimonial relationship as they play no part on it as it is their privacy? They are interested to prescribe the anti depression medication? Some doctors even refer it as a psychiatric disorders or psychology

Kindly elaborate

TEOKIMHOE

Back to top

Anonymous

Posted: Wed Jun 20, 2007 8:14 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

One of the reason the cause of emotional disorders in matrimonial relationship both parties do not agree each other on how to value the relationship.As the result their families broke off.

They do not try to avoid and still repeat on doing the sensitive issues that cause the emotional disorders. Each time they ask for forgiveness that aggravates the emotional disorders, anxiety, depression , apathy and delusions of PD patient. Some doctors even are not playing a part on helping instead prescription of anti depression.

Kindly elaborate

TEOKIMHOE

Back to top

Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Wed Jun 20, 2007 3:59 pm Post subject:

——————————————————————————–

Thank you for your comments.
_________________
Michael S. Okun, M.D.

Back to top

Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Wed Jun 20, 2007 4:01 pm Post subject:

——————————————————————————–

We prefer to address these problems in a multidisciplinary fashion. A licensed clinical social worker, marriage counseling, and when necessary pharmacological approaches for mood disorders…

It takes a multiprong and tailored approach as each situation is different.
_________________
Michael S. Okun, M.D.

Back to top

Dear Doctor,

I refer to my articles.I had seen the Psychiatrist for our matrimonial relationship in the past and the more I complaint the heave medication would be given as I was a trouble maker in order to calm down my emotional disorders and it was not a successful treatment.In order to communicate amongst each other in connection with our matrimonial relationship is it advisable to consult Psychology Centre?

Kindly advise.

TEO KIM HOE

Back to top

Dr. FernandezJoined: 20 Jan 2007Posts: 90Posted: Thu Jul 05, 2007 4:15 pm Post subject:——————————————————————————–Definitely. Pharmacotherapy (provided by a psychiatrist) plus psychotherapy (provided by a psychologist), is better than either approach alone.Yours,_________________Hubert H. FernandezBack to topAnonymousPosted: Sat Jul 07, 2007 10:12 pm Post subject: Emotional disorders and Parkinson Disease——————————————————————————–
Dear Doctor,I have seen the doctor of psychologist and was told to do the text on Urinary Metabolic Profile and Kryptopyroles and were part of nutritional diagnostic testing for mood disorder.Do you believe they are related with the emotional disorders?Are they effective to reflect the nutritional level that caused the emotional disorder?At present I am taking anti depression drugs i.e. 1l2 tablet Zyprexa Zydis 10 mg, one Luvox 50mg,1/2 of Rivotril 0.5 mg and one Lexapio 10mg at bed time.would I cutdown the medication as they are too repetition?Are they safe of taking antidepression and the effect of sexuality?Kindly elaborateTEOKIMHOEBack to topDr. FernandezJoined: 20 Jan 2007Posts: 90Posted: Sun Jul 08, 2007 7:17 am Post subject:——————————————————————————–Sorry, I do not know about the relationship of urinary metabolic profiles and kryptopyroles and depression. It is not something I routinely do, nor do I know if our psychologists/psychiatrists here do that.What I can tell you in your current medication is that I am concerned you are on zyprexa. It is an anti psychotic drug (usually for hallucinations, but occasionally used for other indications), but this clearly worsens PD. I would get off the drug if I were you. The only 2 antipsychotic drugs that PD patients can safely take are quetiapine and clozapine. All ther rest may worsen PD.Yours,_________________Hubert H. FernandezBack to topAnonymousPosted: Mon Jul 16, 2007 4:24 am Post subject: Emotional disorders and Parkinson Disease——————————————————————————–Dear Doctor,Thank you for the advices.My doctor stops me from taking antidepression drugs i.e. 1l2 tablet Zyprexa Zydis 10 mg, one Luvox 50mg,1/2 of Rivotril 0.5 mg and one Lexapio 10mg at bed time.My doctor replaces them with Seroquel 25mg two tablets and 1/2 of Rivotril 0.5mg at night.My medications for PD i.e. one sinemet 25/100 two timeswith one requip 4mg three times per day.I am given one Benzhexol HCL 2mg three tablets per day fortreatment of drooling of Saliva.I was told it is expensive to have BTX treatment for salivary drooling and potential side effects of BTX. It is effective for three months.
Kindly advise

TEOKIMHOE

Back to top

Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of FloridaPosted: Tue Jul 17, 2007 12:35 pm Post subject:——————————————————————————–
Botox can be effective for drooling, but is expensive and does need to be repeated every 3-4 months._________________Michael S. Okun, M.D.Back to top
Posted by Hero Teo at 8:32 AM

0 comments

Tags: General by heroteo
No Comments »

Posted: Wed Jun 20, 2007 6:49 pm Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

There are reasons that cause emotional disorders on PD patients. I am one of the suffers for many years. It is related with my matrimonial relationship. There are certain issues are sensitive to me but not for partner. the emotional disorders causes me depression, anxiety, and sleep disorders.

Some doctors treat it as their privacy and refer to psychiatric or counselling . They prescribe antidpression doses to relieve the disorders as they are not trained in this field.

What are the role of the PD specialist for the emotional disorders is it limited only presciption antidepressions drugs only? They refer the emotional disorders as a psychistric or psychotherapy.

Kindly elaborate the above

TEOKIMHOE
Thanls

TEOKIMHOE

Back to top

Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Wed Jun 20, 2007 8:46 pm Post subject:

——————————————————————————–

It depends on what the comfort level of your PD specialist has. Some do not even prescribe anti-depressants and anti-anxiety agents. They simply refer to a psychiatrist and psychologist.

Others prescribe the medications but do not do psychotherapy, so they refer to psychologist or marriage and family counselor but give the medications.

A few do both pharmaco- and psycho-therapy.

Yours,
_________________
Hubert H. Fernandez

Back to top

Anonymous

Posted: Thu Jun 21, 2007 3:59 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

I am suffering emotional orders for many years. I have consulted marriage counselling and psychiatrist for treatment.
They are not helpful for my sickness as they listen to one side of story as the suffer in in trouble in the matrimonial relatinship with his/her partner.

In this connection I have to thank Dr, Chew Nee Kong of Pantia Cheras Hospital Kuala Lumpur who is the Movement Disorders Specialist who diagnosed my emotional disorders in my matrimonial relationship with my partner i.e without considerate for doing things and hurting me and sensitive issues that I do not accept it . I lost my dignity and respect in the society. Therefore he slowdowns my emotional disorders,

From the above experience some emotional disorders to be cured not by medication but my observation.

Kindly elaborate’

TEOKIMHOE

Back to top

Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Thu Jun 21, 2007 5:31 pm Post subject:

——————————————————————————–

Dear Teo,
I can’t offer any information additional to that given by Dr. Fernandez, unfortunately. Very often, a good and sensitive marriage counselor is the answer; sometimes, antidepressant medication is the best solution. It sounds as though you found the ideal physician in Dr. Chew Nee Kong, and I only wish everyone was as fortunate.
_________________
Best regards,
Kathrynne Holden, MS, RD
-L

Tags: General by heroteo
No Comments »

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Anonymou

Posted: Wed Jun 20, 2007 6:49 pm Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

There are reasons that cause emotional disorders on PD patients. I am one of the suffers for many years. It is related with my matrimonial relationship. There are certain issues are sensitive to me but not for partner. the emotional disorders causes me depression, anxiety, and sleep disorders.

Some doctors treat it as their privacy and refer to psychiatric or counselling . They prescribe antidpression doses to relieve the disorders as they are not trained in this field.

What are the role of the PD specialist for the emotional disorders is it limited only presciption antidepressions drugs only? They refer the emotional disorders as a psychistric or psychotherapy.

Kindly elaborate the above

TEOKIMHOE
Thanls

TEOKIMHOE

Back to top

Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Wed Jun 20, 2007 8:46 pm Post subject:

——————————————————————————–

It depends on what the comfort level of your PD specialist has. Some do not even prescribe anti-depressants and anti-anxiety agents. They simply refer to a psychiatrist and psychologist.

Others prescribe the medications but do not do psychotherapy, so they refer to psychologist or marriage and family counselor but give the medications.

A few do both pharmaco- and psycho-therapy.

Yours,
_________________
Hubert H. Fernandez

Back to top

Anonymous

Posted: Thu Jun 21, 2007 3:59 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

I am suffering emotional orders for many years. I have consulted marriage counselling and psychiatrist for treatment.
They are not helpful for my sickness as they listen to one side of story as the suffer in in trouble in the matrimonial relatinship with his/her partner.

In this connection I have to thank Dr, Chew Nee Kong of Pantia Cheras Hospital Kuala Lumpur who is the Movement Disorders Specialist who diagnosed my emotional disorders in my matrimonial relationship with my partner i.e without considerate for doing things and hurting me and sensitive issues that I do not accept it . I lost my dignity and respect in the society. Therefore he slowdowns my emotional disorders,

From the above experience some emotional disorders to be cured not by medication but my observation.

Kindly elaborate’

TEOKIMHOE

Back to top

Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Thu Jun 21, 2007 5:31 pm Post subject:

——————————————————————————–

Dear Teo,
I can’t offer any information additional to that given by Dr. Fernandez, unfortunately. Very often, a good and sensitive marriage counselor is the answer; sometimes, antidepressant medication is the best solution. It sounds as though you found the ideal physician in Dr. Chew Nee Kong, and I only wish everyone was as fortunate.
_________________
Best regards,
Kathrynne Holden, MS, RD
–
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/

Back to t0p

Tags: General by heroteo
No Comments »

Posted: Fri Jun 08, 2007 8:52 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

I was refered by Dr. Kathrynne Holden, to post the following:

As emotional and cognitive disorders are common in Parkinson’s disease, but are frequently overlooked or undertreated.

Some PD patients are aware of the emotional disorders and associated with ther matrimonial relationship when they come to certain disagreements. As the result they have depressive,delusions and sleep disorders. They usually refer to marriage counselling or psychiatric consultation.

In this connection I have the emotional disorders for the past of 20 years and they are associated with the matrimonial relationship until recently I find out they are byproduct of PD. All efforts going to marriage counselling or psychiatric are frustrating.

I understand there are between 40-60% PD patients have emotional disorders. Sensitivity to certain behaviours,issues and understanding are the causes of bad matrimonial relationship. They are the byproduct of
anxiety,phobias,apathy,hallucinations,delusions and sleep disorders.

Kindly advise me how to address the psychiatric and cognitive side effects of anti-Parkinson medications and surgical treatments.

Thanks

TEOKIMHOE

Back to top

Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Fri Jun 08, 2007 7:43 am Post subject:

——————————————————————————–

Dear Teo,
These are very good questions to raise, because there are many emotional as well as cognitive changes that may occur as PD progresses. Emotional instability, depression, attitudes toward sexuality, all may occur.

However, this is outside my scope of practice as a registered dietitian. This requires the efforts of a neurologist who specializes in PD who can determine whether counseling or medications or a combination of both is the best approach.

I highly recommend you address this question to “Ask the Doctor” — the doctors have wide experience in the many mental and emotional changes occurring in PD.
_________________
Best regards,
Kathrynne Holden, MS, RD
–
For a Parkinson Tip

Okun,

Back to top

Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sat Jun 09, 2007 1:30 am Post subject:

——————————————————————————–

There are high rates of depression, anxiety, apathy and other mood/emotional disorders in PD. PD also causes stress on marriages. The two must BOTH be treated. I suggest SSRI’s, clinical psychiatry, psychology, and marital counseling. I take these problems seriously in my patients and I use the multidisciplinary team.
_________________
Michael S. Okun, M.D.

Back to top

Anonymous

Posted: Sat Jun 09, 2007 5:44 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,

I have known PD as an illness of the “body, mind and soul

As for me my psychiatric problems have been normal. I have improved my matrimonial relationship.

I understand emotional disorders are the byproduct of PD and it is more difficult to treat than the movement problem as new discovery made drastic improvement in the treatment of the movement problem in PD. Cognitive disorders are common in PD - anxiety,depression etc

As I have difficult agility’s my doctor increases my medication from one requip 0.25mg to two, three and four doses weekly three times a day.

For antidepression: one fluvoxamine maleate 50mg and Rivotril 0.5mg at night

He will cutdown my sinemet 25/100 and Jumex 5mg as times goes by to optimize the medication. As sinement has sideeffect on me sleepless at night, bad dream, agility’s and emotional stress.

Kindly comment

TEOKIMHOE

Back to top

Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Sun Jun 10, 2007 8:19 am Post subject:

——————————————————————————–

I think you asked a similar question on this already that I tried to answer.

Yours,
_________________
Hubert H. Fernandez

Back to top

Anonymous

Posted: Wed Jun 20, 2007 7:59 am Post subject: Emotional disorders and Parkinson Disease

——————————————————————————–

Dear Doctor,
‘
In view of my articles as the matrimonial relationships are the part causes of emotional disorders. Are they helpful for both parties to avoid their sensitive issues that cause emotional disorders?

What is the part of doctors to maintain the matrimonial relationship? Medication? Counselling?

Do you agree the above is the best way to counter the emotional relationship than the medication?

Why some doctors consider them as matrimonial relationship as they play no part on it as it is their privacy? They are interested to prescribe the antidepression medication? Some doctors even refer it as a psychiatric disorders or psychology

Kindly elaborate

TEOKIMHOE

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Anonymous

Posted: Wed Jun 20, 2007 8:14 am Post subject: Emotional disorders and Parkinson Disease

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Dear Doctor,

One of the reason the cause of emotional disorders in matrimonial relationship both parties do not agree each other on how to value the relationship.As the result their families broke off.

They do not try to avoid and still repeat on doing the sensitive issues that cause the emotional disorders. Each time they ask for forgiveness that aggravates the emotional disorders, anxiety, depression , apathy and delusions of PD patient. Some doctors even are not playing a part on helping instead prescription of antidepression.

Kindly elaborate

TEOKIMHOE

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Wed Jun 20, 2007 3:59 pm Post subject:

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Thank you for your comments.
_________________
Michael S. Okun, M.D.

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Wed Jun 20, 2007 4:01 pm Post subject:

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We prefer to address these problems in a multidisciplinary fashion. A licensed clinical social worker, marriage counseling, and when necessary pharmacological approaches for mood disorders…

It takes a multiprong and tailored approach as each situation is different.
_________________
Michael S. Okun, M.D.

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Tags: General by heroteo
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Posted: Wed Jun 20, 2007 6:49 pm Post subject: Emotional disorders and Parkinson Disease

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Dear Doctor,

There are reasons that cause emotional disorders on PD patients. I am one of the suffers for many years. It is related with my matrimonial relationship. There are certain issues are sensitive to me but not for partner. the emotional disorders causes me depression, anxiety, and sleep disorders.

Some doctors treat it as their privacy and refer to psychiatric or counselling . They prescribe antidpression doses to relieve the disorders as they are not trained in this field.

What are the role of the PD specialist for the emotional disorders is it limited only presciption antidepressions drugs only? They refer the emotional disorders as a psychistric or psychotherapy.

Kindly elaborate the above

TEOKIMHOE

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Wed Jun 20, 2007 8:46 pm Post subject:

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It depends on what the comfort level of your PD specialist has. Some do not even prescribe anti-depressants and anti-anxiety agents. They simply refer to a psychiatrist and psychologist.

Others prescribe the medications but do not do psychotherapy, so they refer to psychologist or marriage and family counselor but give the medications.

A few do both pharmaco- and psycho-therapy.

Yours,
_________________
Hubert H. Fernandez

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Tags: General by heroteo
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Posted: Fri Jun 01, 2007 10:46 am Post subject: Agility

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Dear Dr. Rodriquez,
Fri Jun 01, 2007 4:44 am Post subject: Q: Agility

I was referred by Dr.Kathrynne Holden to post the following question for your elaboration and advise:

I am a PD patient for the past of two years and is on
medication i.e. one each sinemet 25/100 in three times and one Jumex in two times a day.

I have agility’s difficulties during my exercises in gym and daily life as follows:

1.Able to move quickly or easily and neat in movement; nimble

2.Quickly to grip/seizing something firmly both from fingers/ hand to take

3.Easily to lost my grip on the slope

4.Agile mind to think quickly or acute

My physical trainer told me I have difficulties of agility
during his physical program and is not improving.

Is it an aging process or advancing stages of PD?

Kindly advise.

TEO KIM HOE

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Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Fri Jun 01, 2007 8:00 am Post subject:

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Dear Teo,
These are very good questions, but again I must request that you post them to “Ask the Doctor,” as my practice is concerned with nutrition.
_________________
Best regards,
Kathrynne Holden, MS, RD
–

I was refered by Dr. Kathrynne Holden to post the following for your elaboration and advise:-

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Sun Jun 03, 2007 8:04 pm Post subject:

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Sorry, Dr. Rodriguez is unavailable right now. It is difficult to get Internet access at our hotel…

But I think, to answer your question, it could be the progression of your PD. Or you are not optimized in your current medication.

Yours,
_________________
Hubert H. Fernandez

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Anonymous

Posted: Mon Jun 04, 2007 1:46 am Post subject: Agility and Medication

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Dear Doctor,

Thank you for your email and am advised by my doctor to optimise my medication as follows”

l. one dose of Sinemet 25/100 for morning, afternoon and evening

2. one Jumex 5gm for morning and afternoon.

3. Requip O.25mg one each for morning, midday and evening for first week and increase two doses for 2 week , 3 doses for 3 week and 4 doses for fourth week.

4. one dose of Rivotril 0.5 mg for my insomnia at bed time as I have bad dream at night due to the side effect of Sinement.

I was told by doctor that he will increase my Requip medication after the 4 weeks and decrease the sinemet doses as it is too powerful for me.

Kindly advise

Best regards

Teo Kim HOe

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Anonymous

Posted: Mon Jun 04, 2007 2:18 am Post subject: agility and Medication

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Dear Doctor,

Thank you for your email and be informed my doctor has optimized my doses of Parkinson as follows:

one dose of Requip 0.25 mg for the first week, increases to two doses for 2 week, 3 doses for third week and 4 doses for four week. All are in three time a day

The Requip will be increased further after the 4 weeks as Sinemet would cut down to optimized the medication. Sinemet is too strong for me as I am in stage 2 of PD.

Kindly advise

Best regards

Teo Kim Hoe

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Dr. Okun

Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Fri Jun 08, 2007 10:58 am Post subject:

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I would recommend you follow your doctor’s advice.
_________________
Michael S. Okun, M.D.

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Tags: General by heroteo
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Q: Emotional disorders and Parkinson Disease

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Anonymous

Posted: Thu Jun 07, 2007 7:49 pm Post subject: Q: Emotional disorders and Parkinson Disease

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As emotional and cognitive disorders are common in Parkinson’s disease, but are frequently overlooked or undertreated.

Some PD patients are aware of the emotional disorders and associated with ther matrimonial relationship when they come to certain disagreements. As the result they have depressive,delusions and sleep disorders. They usually refer to marriage counsellling or psychiatric consultation.

In this connection I have the emotional disorders for the past of 20 years and I do not aware that they are assocaited with the matrimonial relationship until I was discovered it is associated with PD. All efforts going to marriage councelling or psychiatric are frustrating.

Kindly advise me how to address the psychiatric and cognitive side effects of anti-parkinsonian medications and surgical treatments.

Thanks

TEOKIMHOE

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Kathrynne Holden, MS, RD

Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Fri Jun 08, 2007 7:43 am Post subject:

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Dear Teo,
These are very good questions to raise, because there are many emotional as well as cognitive changes that may occur as PD progresses. Emotional instability, depression, attitudes toward sexuality, all may occur.

However, this is outside my scope of practice as a registered dietitian. This requires the efforts of a neurologist who specializes in PD who can determine whether counseling or medications or a combination of both is the best approach.

I highly recommend you address this question to “Ask the Doctor” — the doctors have wide experience in the many mental and emotional changes occurring in PD.
_________________
Best regards,
Kathrynne Holden, MS, RD
–
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/

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Anonymous

Posted: Fri Jun 08, 2007 4:35 pm Post subject: Emotional disorders and Parkinson Disease

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Dear Doctor,

Is it due to the sideeffect of my PD i.e Sinemet 25/100 one each per meal and one Jumex 5mg in two meals that I have emotional disorders associated with matrimonial relationship with my wife? I am now sensitive on any issues associated with matrimoniaL relationship resulting I have depressive, anxiety.apathy and sleep disorders.It is associated with psychiatric and cognitive disorders

I have consulted the doctor and now am taking requip 0.25 one each per meal and slowly increase from two, three, four doses for week besides the sinemet and jumex. In additiona I am taking fluvoxamine maleate 50mg and Rivotril 0.5 mg for antidepressive disorders and anxiety. I am now not interested to taking part in gmx which I use to as I have sensitive to the exercises’as I have difficulties with movement agilities.

Kindly elaborate the above;”

Thanks

TEOKIMHOE

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Dr. Fernandez

Joined: 20 Jan 2007
Posts: 90

Posted: Sun Jun 10, 2007 7:59 am Post subject:

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Depression, anxiety, apathy and sleep disorders are quite common in PD. From the tone of your e-mail and from the various e-mails you have sent us trying to know as much as you can about PD, you are probably not apathetic. But you definitely can be depressed, anxious and have sleep problems.

40-50% of PD patients get depressed. 20-30% get anxious, and almost all have sleep problems. One other thing to consider is that depression alone can cause anxiety (called agitated depression) and sleep disorders. Thus, it is possible that this could all stem from depression, and it is possible that these are 3 separate entities as well.

I would advice you to be more aggressive in treating your depression. Perhaps you need a higher dose of your anti-depressant? Perhaps you need a 2nd or a 3rd agent to help you? I would also strongly consider you to undergo psychotherapy to augment the action of your anti-depressants. If you are having marital problems, it is worth going to a marriage or family counselor. The combination of pharmacotherapy and psychotherapy is better in controlling depression that either one alone.

Yours,
_________________
Hubert H. Fernandez

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Tags: General by heroteo
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