HeroTeo - The Parkinson’s Fighter

Anonymous
Posted: Tue Aug 18, 2009 11:29 pm Post subject: Seroquel

I seem to remember postings on Seroquel — its pluses and minuses. But I can’t locate them. Any comment, doctors? Seroquel has been prescribed for me because I’ve been hallucinating. The dose is one .25 mg tablet at bedtime. Anonymous
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Sat Aug 22, 2009 8:30 am Post subject:

Quetiapine (seroquel) is one of our first line treatment for hallucinations in PD. It is generally well tolerated. Because of this, it is often also used for other conditions such as insomnia, and agitation. However, just like any drug, it has its share of side effects. It can cause sedation (that is why it is given at night and used for insomnia as well), confusion, lightheadedness, and rarely, it can worsen PD, but not usually. Yours,_________________Hubert H. Fernandez

Tags: General by heroteo
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Anonymous
Posted: Tue Aug 18, 2009 9:36 am Post subject: Progression.

There is a PwP in our area who has had Parkinson’s for at least 18 years and it does not seem to have progressed at all.He is still on Mirapex and a small amount of Sinemet at night. Is it possible that on rare occassions Parkinson’s does stop progressing or that the progression is so slow it hardly notices?Thank you
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Tue Aug 18, 2009 10:06 pm Post subject:

Definitely, the progression in PD is a very individual thing. Some of our patients progress so slowly that we hardly see a difference from year to year. Some patients are more devastated by the illness and we see a change whenever they visit us in clinic. And the majority of patients fall in between these two extremes. Of course, there is a possibility that your neighbor does not have PD but a mimicker of PD…? Yours,_________________Hubert H. Fernandez

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Posted: Fri Aug 07, 2009 4:21 pm Post subject: Post of the Week: Risk of Stroke and Parkinson’s

Despite potential issues with the methods in this study from Switzerland it is interesting that when examining a large database two issues emerged: 1- Risk of PD diagnosis was increased if a previous stroke, 2- the risk of first time ischemic stroke was increased in PD. These findings will need to be confirmed, but raise the possibility of some association of PD and stroke. Parkinsonism Relat Disord. 2009 Jul 27. [Epub ahead of print]Links Risk of stroke in patients with idiopathic Parkinson disease. Becker C, Jick SS, Meier CR. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Switzerland. PURPOSE: Large population based studies on the association of Parkinson disease (PD) with stroke are scarce. This study aimed to quantify the risk of a first-time diagnosis of idiopathic PD in patients with a history of stroke, and to assess incidence rates for stroke in PD patients. METHODS: We used the UK-based General Practice Research Database to compare the prevalence of stroke/TIA in newly diagnosed PD patients and in a matched comparison group without PD between 1994 and 2005. We conducted a follow-up study with a nested case-control analysis to quantify the risk of incident stroke/TIA in relation to a previous PD diagnosis. RESULTS: A history of stroke/TIA was associated with a significantly increased relative risk of being diagnosed with PD compared to patients without such a history (adj. odds ratio [OR] 1.65, 95% confidence intervals [CI] 1.47-2.00). In the cohort study, the crude incidence rate ratios (IRRs) for incident hemorrhagic stroke, ischemic stroke or TIA were 0.66 (95% CI 0.26-1.72), 1.46 (95% CI 1.03-2.07) and 1.86 (95% CI 1.40-2.47), respectively. CONCLUSIONS: In this large observational study the risk of a PD diagnosis was significantly increased after a previous stroke event, as was the risk of a first-time ischemic stroke in newly diagnosed PD patients compared to persons free of PD._________________Michael S. Okun, M.D.

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Posted: Wed Aug 05, 2009 12:12 pm Post subject: Having depression before your diagnosis of PD affects QOL

Dear forum members,

The relationship between depression and quality of life in PD has been something we feel is deserving of more research. A small study was recently published commenting on this relationship. Interestingly, if you had depression prior to your PD diagnosis it may affect your quality of life (QOL) post diagnosis (or be related to it). The abstract is below: Parkinsonism Relat Disord. 2009 Jul 27. [Epub ahead of print]Links Impact of pre-morbid depression on health-related quality of life in non-demented Parkinson’s disease patients. Klepac N, Hajnšek S, Trkulja V. Department of Neurology, University Hospital Centre Zagreb, Zagreb University School of Medicine, Kispatićeva 12, Zagreb, Croatia. The need to understand and improve health-related quality of life (Hr-QoL) in Parkinson’s disease (PD) has been emphasized. In order to investigate contributions of depression that existed before the onset of typical motor symptoms (”pre-PD depression”), idiopathic non-demented non-psychotic patients with (n = 32) and without (n = 120) a history of pre-PD depression, free of relevant comorbidity, calliper-matched for age, education and disease duration were evaluated for motor and non-motor disease aspects and Hr-QoL (Parkinson’s Disease Questionnaire 39, PDQ-39). History of pre-PD depression was independently associated with higher actual levels of depression and anxiety, poorer sleep quality and mental set shifting, which all contributed to poorer Hr-QoL. Mediation analysis demonstrated significant indirect effects (mediated through the effects on mood/emotion/sleep and/or cognition) of pre-PD depression on PDQ summary index and subscales, but also direct (non-mediated) effects on emotional well-being and body discomfort subscales independent of the sociodemographic, motor/non-motor disease or treatment-related characteristics. Data indicate that for a given level of motor/non-motor PD symptoms severity, history of pre-PD depression contributes to poorer Hr-QoL._________________Michael

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nonymous
Posted: Wed Aug 12, 2009 7:54 pm Post subject: melatonin

Is the use of a otc sleep aid containing melatonin harmful to a person with Parkinsons?Back to top

Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Thu Aug 13, 2009 5:35 pm Post subject:

I am not aware of this being harmful. I also do not think this is the best sleep aid in PD. Make sure you report this to your doctor and get a specific sleep disorder diagnosis and have he/she tailor the therapy. Some people say melatonin is good for jet-lag!_________________Michael S. Okun, M.D.

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http://www.patientslikeme.com/forum/show/51124

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http://www.patientslikeme.com/forum/show/50951

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People with dentures have excess saliva as dentures are foreign
substances in the mouth and the mouth produces excess saliva as a reaction perhaps treating the dentures as food”

Dr. Okun Joined: 19 Jan 2007 Posts: 251 Location: University of Florida

Posted: Fri Aug 07, 2009 3:35 pm    Post subject: Thanks for the comment.Also remember botox and anticholinergics can dry you up but may also lead to cavities! _________________ Michael S. Okun, M.D.There are complaint by the parkinson’s patient to the doctor   the drooling  saliva and dentures Therefore Movement disorder specialist deal with medication to minimise the effect of saliva on the patient. They classified the excess of saliva is the slow saliva swallowing by PD  neither the cause the saliva on dentures The dentist classified the  saliva developing dentures slippery and loose is a gap develop  between the denture and the gummy ridge. . Therefore the denture may need repeated relines. Shrinkage of the bone and gums can be minimized or prevented with a proven technique Dr. Okun Joined: 19 Jan 2007 Posts: 251 Location: University of Florida Posted: Sun Aug 09, 2009 8:39 pm Post subject: Thanks for the added comment. _________________ Michael S. Okun, M.D.

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nonymous	Posted: Tue Aug 04, 2009 5:30 am Post subject: Leg freezing Are they differences?Does Up/down stair or cycling cause leg freezing?Does Sitting, walking and standing cause leg freezing?Kindly elaborate
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Dr. Okun Joined: 19 Jan 2007 Posts: 251 Location: University of Florida	Posted: Tue Aug 04, 2009 8:58 pm Post subject: There is no rhyme or reason why some people freeze and some people do not? Why some people respond to cueing and some do not? Why some people’s freezing responds to meds and some does not?These are million dollar questions and we need more research to unlock their answers.One potential answer is that PD is not one disease, and that there are many causes and variations….I know not very satisfying! _________________ Michael S. Okun, M.D.

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http://www.patientslikeme.com/forum/show/50312

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