HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Is Excessive Shaking Of Hands A Side Effect Of Stopping Parkitidin Tablet?

Posted on Wed, 26 Aug 2015

Question: Hello Doctor - My dad is 67 years and has been having Parkinson for last 4 years. 4 months back he went through Hernia operation and was doing good but little weak. Last week, he was unable to pass urine and his sodium level was reduced to 120. He is currently fitted with Catheter and has been asked to keep it for 2 weeks and sodium level is back to normal. For Parkinson, he was taking tablets Syncopane 50 mg and Parkitidine. He is now asked to take Syncopane 50 and Vinq. He is unable to walk or sit by himself when his left hand is shaking. Is that because stopping Parkitidine or effect of sodium ? Please advise

Answered by Dr. Neeraj Kumar (1 hour later)

Brief Answer:
Possibilty of drug related (stoppage of parkitidine) effect

Detailed Answer:
Hello XXXXXXX
I have gone through your question and understand your concerns.
Parkinson's disease is progressive disorder . The response to drug decraeses with time and side effects increases. Elderly patients with multiple drug intake are prone for metabolic derangement.
Hyponatremia may be cause of worsening in sensorium and weakness but tremors and tone is abnormal due to decreased medication.
If sodium is normal and other parameters are ok then again parkitidine may be added or dose of syncapone may be increased. Also proper follow up with neurologist is required for drug related side effects.
HOpe you found the answer helpful .
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Neeraj Kumar (2 hours later)

Thank you doctor. I observed that when he sleeps well, he is able to stand or sit on his own for about 30 mins and moment his hands shakes, he feels extremely tired and unable to move.
I will consult my Neurologist to talk about increasing dosage but in the meantime, I do have the following question

1) How long does it typically takes for the muscles to fully recover for regaining sodium?
2) Is Vinq 10 mg good alternative for Parkiditine?
3) Can I give natural protein enriched nuts like Almond, Cashew etc in minimal quality?

Thanks again

Answered by Dr. Neeraj Kumar (3 hours later)

Brief Answer:
Vin Q 10 is an antioxidant capsule

Detailed Answer:
hello XXXXXXX
Muscle strength and consciousness recovery may take 1-2 weeks.
Vin Q 10 is an antioxidant capsule and is not a replacement of parkitidine. It has some neuro protective effect.
You can give such natural dry fruits but not with syncapone. There should be gap of 1 hour between syncapone intake and any food item.
Uncontrolled tremors are hard to control.
Surgical options are also there at some movement disorder centers helping in controlling the symptoms and drug doses.
Hope you found the answer satisfactory.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Neeraj Kumar (37 hours later)

Thanks Doctor. Per your suggestion, I consulted with the doctor that stopped Parkitidine during some treatment last week. After I talked about tremor issues, he suggested to increase the dose of syndopa from 50 mg to 110 mg. However, instead of 3 doses, he recommended only 2 doses (1-0-1) per day. With first 2 doses, he was able to walk after 1 week and seemed perfectly normal but it was effective only for 2-3 hours. Yesterday night, there was no effect at all.. Is it good idea to request a) 3 doses of Syndopa 110mg per day b) Mild sleeping dose as he is unable to sleep when there is hand tremor.

Just to summarize: Here are his current medication

Syndopa 110mg (1-0-1)
Vinq 10 (1-0-0)
Gabantin 100 (0-0-1)
Ropark Xl (1-0-0)
Telma 40 (1-0-0)

Thanks again

Follow up: Dr. Neeraj Kumar (9 hours later)

Just called the doctor that requested to stop parkitidine.. He suggested the following

1) Requested to increase synod 11mg from 1-0-1 to 1-1-1
2) Added Amantrel 100 mg 1-0-0
3) Restil 0.5 for sleeping.

Second opinion by you would be much appreciated.

Answered by Dr. Neeraj Kumar (2 hours later)

Brief Answer:
Detailed answer below

Detailed Answer:
Hello XXXXXXX
Treatment advised is good. The dose increase in parkinson's disease is usually gradual as many patients starts having side effects.
Dose increase is done untill patient is able to do most of his routine activities without any much difficulty.
The target of treatment is not to try to completely improve the symptoms.
Syndopa dose may be increased later on and also substituted with 100+25 combination. If needed Controlled release formulation may be advised later on if symptoms of early morning stiffness is present.
Syndopa should not be taken with any eatables for good absorption.
Amantadine and rasagiline are also drugs indicated for parkinson.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj