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Are Carbidopa And Levodopa Effective In Managing Parkinson's Disease?
Question: patient started carbidopa/levodopa for Parkinsonian symptoms associated with longstanding fronto-temporal dementia -- began this therapy approx. 9 days ago . Has developed emotional lability with frequent sobbing ,problems with settling down for sleep ,very early awakening with confusion,increased vocal activity and marked anxiety . Also increasing periods of aggressive behaviour and apprehension with sitting,climbing & descending stairs ,along with frequent mood changes . If these problems are attributable to this new medication ,I must question whether the potential advantages outweigh the side effec
ts . Would appreciate your thoughts on this . As an aside I will mention that I am a retired physician and the patient is my wife of 57 years (she is 78 years of age) . e-mail address is : YYYY@YYYY Thanks XXXXXXX A.McPhail M.D.
ts . Would appreciate your thoughts on this . As an aside I will mention that I am a retired physician and the patient is my wife of 57 years (she is 78 years of age) . e-mail address is : YYYY@YYYY Thanks XXXXXXX A.McPhail M.D.
Brief Answer:
She may be having associated bipolar disorder
Detailed Answer:
Hello Dear. As you are a physician yourself you may be knowing about the condition very well.
Some of the most common side effect of levodopa/carbidopa are-
1. dizziness
2. loss of appetite
3. diarrhea
4. dry mouth
5. mouth and throat pain
6. constipation
7. change in sense of taste
8. forgetfulness or confusion
9. nervousness
10. nightmares
11. difficulty falling asleep or staying asleep
12. headache
13. weakness
But this may arise only after long term use atleast for a couple of months and not within 9 days.
Your wife seems to be having associated psychiatric disorder like bipolar disorder along with fronto-temporal dementia. You may need to get treated for that first rather than parkinosnism. Also congnitive behavioural therapy is the most required treatment as of now for her.
Is she on any other drug which may cause interaction with carbidopa/levodopa?
Some products that may interact with this drug include: antipsychotic drugs (such as chlorpromazine, haloperidol, thioridazine), certain drugs used to treat high blood pressure (such as methyldopa, reserpine), tetrabenazine.
Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction.
Regards
Dr Sanjay Kini
She may be having associated bipolar disorder
Detailed Answer:
Hello Dear. As you are a physician yourself you may be knowing about the condition very well.
Some of the most common side effect of levodopa/carbidopa are-
1. dizziness
2. loss of appetite
3. diarrhea
4. dry mouth
5. mouth and throat pain
6. constipation
7. change in sense of taste
8. forgetfulness or confusion
9. nervousness
10. nightmares
11. difficulty falling asleep or staying asleep
12. headache
13. weakness
But this may arise only after long term use atleast for a couple of months and not within 9 days.
Your wife seems to be having associated psychiatric disorder like bipolar disorder along with fronto-temporal dementia. You may need to get treated for that first rather than parkinosnism. Also congnitive behavioural therapy is the most required treatment as of now for her.
Is she on any other drug which may cause interaction with carbidopa/levodopa?
Some products that may interact with this drug include: antipsychotic drugs (such as chlorpromazine, haloperidol, thioridazine), certain drugs used to treat high blood pressure (such as methyldopa, reserpine), tetrabenazine.
Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction.
Regards
Dr Sanjay Kini
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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