Understanding the Side Effects of Parkinson’s Medications

For many people with young onset Parkinson’s, medications form the cornerstone of symptom management and maintaining quality of life. These medications are carefully tailored by your neurologist to target specific issues—whether that’s tremor, stiffness, or reduced mobility. However, as with any treatment, there are side effects, and understanding them is an important part of managing your condition effectively.

Why medications are essential

Your body isn’t producing enough dopamine anymore. Parkinson’s medications work by replacing the levels of dopamine (a neurotransmitter) or mimicking its action in the brain so that your brain can use it to send messages to your body. The most common treatment, levodopa, is often supported by other drug categories such as dopamine agonists, anticholinergics, MAO-B inhibitors, COMT inhibitors, and amantadine. This approach is designed to address your most troublesome symptoms, ensuring that each component of your daily life, from work to family activities, is supported. It is vital to adhere to your prescribed schedule to maintain a consistent level of medication in your system, minimising fluctuations in your symptoms.

How medications are delivered

When managing Parkinson’s, the way your medication is delivered can be just as important as the medicine itself. The delivery method is tailored to your needs and your body’s ability to absorb and utilise the medication. From oral medications, injections and subcutaneous pumps to transdermal patches and nasal sprays, there are lots of ways to get the dopamine back into your system.

A range of side effects

While these medications can significantly improve your motor function, several side effects may occur.

  • Motor fluctuations and dyskinesia: Some individuals may experience involuntary, erratic movements (dyskinesia) or notice that the effectiveness of their medication gradually wears off before the next dose. These fluctuations can cause periods when symptoms seem to return or worsen.
  • Gastrointestinal issues: Nausea and an upset stomach are relatively common, which can impact appetite and overall nutrition.
  • Sleep disturbances: Irregular sleep patterns, insomnia, and even excessive daytime sleepiness may develop. For young onset individuals balancing professional and family commitments, these disturbances can add an extra layer of challenge.
  • Cognitive and mood changes: Changes in concentration, memory, or mood are sometimes reported, and these can influence social interactions or how you manage day-to-day activities.

Other Effects

Dizziness, low blood pressure, dry mouth, and blurred vision are also observed with some treatments. It is important to realise that everyone’s experience with medication side effects may differ.

Impulse Control Disorders (ICDs) and Other Behavioural Side Effects

A particularly significant side effect to be aware of—especially when dopamine agonists are part of your treatment—is the risk of developing Impulse Control Disorders (ICDs). ICDs involve a reduced ability to resist urges that could lead to compulsive and sometimes harmful behaviours. The emergence of these behaviours may affect not only your personal life but also place additional stress on your family and care partners. These behaviours may include:

  • Pathological Gambling: An uncontrollable urge to gamble despite negative consequences.
  • Compulsive Shopping: Excessive spending that interferes with your financial wellbeing.
  • Hyper-sexuality: A marked increase in sexual thoughts and behaviours, which might be out of character.
  • Binge Eating: An urge to overeat or consume food excessively.
  • Punding: A repetitive, non-goal oriented activities that can occupy hours of your time, leaving you distressed when you try to stop.

If you notice changes in your behaviour, it is important to discuss these immediately with your partner, friend or family member and your care team. Early recognition can lead to adjustments in medication, such as lowering doses or switching treatments or delivery methods, often resulting in a reduction of these symptoms. Remember, these side effects are not uncommon, and help is available.

Managing Side Effects with a Collaborative Approach

Managing the side effects of Parkinson’s medications involves ongoing communication with your care team, including your neurologist, Parkinson’s Nurse Specialist, GP, and pharmacist. Key strategies include:

  • Adhering to Your Prescribed Schedule: This helps maintain an optimal level of medication in your system, reducing the risk of fluctuations and unexpected side effects.
  • Regular Reviews and Home Medicines Reviews (HMR): As Parkinson’s progresses, your medication needs may change. Regular reviews, including pharmacist-led Home Medicines Reviews, ensure that your treatment plan evolves with your condition.
  • Using Dose Administration Aids: Tools like Dose Administration Aids or Websterpaks organise your medication into tamperproof, daily allotments, which is especially useful when managing multiple doses.
  • Discussing Any New Symptoms Promptly: Including changes in behaviour, mood, or cognition. Open dialogue with healthcare professionals will help adjust medications before side effects significantly affect daily life.
  • Avoiding Unsanctioned Supplements: Always consult a health professional before adding herbal supplements, vitamins, or other natural remedies that might interfere with your Parkinson’s medications.

Looking Ahead

Living with young onset Parkinson’s means you are managing not just the physical symptoms, but also the intricacies of a treatment plan that evolves with you. The possibility of developing side effects, including behavioural changes like ICDs, can be challenging. However, with a proactive and collaborative approach—backed by regular checkups, open conversation with your care team, and awareness of your body’s signals—you can manage these side effects while continuing to lead a fulfilling and active life.

Your journey with Parkinson’s might include unexpected hurdles, but you are not alone. Stay informed about your medications, lean on your support network, and make sure that every change in your treatment plan is discussed thoroughly with your entire care team. This approach will help ensure that your treatments remain as effective as possible, safeguarding your independence and enhancing your quality of life.

References

Michael J. Fox Foundation for Parkinson’s Research. (n.d.). Medications for Parkinson’s. Retrieved from https://www.michaeljfox.org/

National Institute for Health and Care Excellence. (2017). Parkinson’s disease in adults: Diagnosis and management (NICE guideline NG71). Retrieved from https://www.nice.org.uk/guidance/ng71

Waller et al. (2021) The initial diagnosis and management of Parkinson’s disease. AJGP Vol. 50, Issue 11.

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