Ves,

I am afraid your brother's doctor doesn't know some of the basics about PD
and/or the pharmacology of Haldol.  Haldol should not be given to PWP.  It
blocks the action of DOPAMINE enough so that it often causes Parkinson's
symptoms in people without PD.  I presume his symptoms of PD got worse with
the Haldol.  Respiridol is supposed to cause less Parkinsonian side effects
but it still can make the PD worse in some cases.  I am also concerned that
your brother may be oversedated with the Ativan.  His falls may be related
either to worsening of his PD or oversedation  and if he is on a medical
unit of a  general hospital rather than a psychiatric unit they probably
have little tolerance for confused behavior and may be too liberal with the
sedation.

As a retired psychiatrist with PD who has not seen the patient and therefore
must make judgements based on what you tell me,  in my opinion,  he should
be seen by a physician competent in both geriatric psychiatry and
knowledgeable about PD  to evaluate whether he is experiencing dementia or
something reversible like medication toxicity.    He should not be put into
a chronic care facility without a good psychiatric + neurologic evaluation.

Good luck and keep us informed of how he is doing.

Charlie

  ----- Original Message -----
From: ves <[log in to unmask]>
To: Charles T. Meyer, M.D. <[log in to unmask]>
Cc: <[log in to unmask]>; marla ross <[log in to unmask]>; wayne
shirley <[log in to unmask]>; diana valenzuela <[log in to unmask]>;
Joyce Bechard <[log in to unmask]>; vestel b. shirley <[log in to unmask]>
Sent: Sunday, January 23, 2000 10:00 PM
Subject: Re: improper meds?


> Wayne Shirley, age 65, weitht 145 lbs (lost 40 pounds in one year)
> REcent dosage:
> sinemet - one CR 50.200 three times daily ( 9 am, 1 pm and 5 pm)
> Haldol:  Prescribed as needed for agitation:  2 mg by injection every four
> hours.  Given three injections in two weeks (jan 8th, 15th, and 17th)
> Risperdal:  1 mg/dose at 8 am and 5 pm.  This medication was stopped on
Jan
> 15th since he was becoming extremely sleepy.  Then resumed on the 21st at
0.5
> mg/dose at 9 am and 5 pm
> Ativan: 1 mg injection every 6 hours as needed or 1 mg by mouth as needed.
> Three injections were issued.  On the 21st there was one injection.  And
two
> injections were administered on the 22nd.
> He fell twice on the 21st and twice more on the 22nd.  He is now in the
> hospital and the doctor is trying to get him committed to an asylum or
another
> geriatric facility.
> He is supsected of also having alzheimers.  I am in the process of getting
his
> affairs straight so he can qualify for medicaid and then get him with me
in
> North Carolina.  It appears as if I am running out of time.
> Thanks, CHarles.
>
> "Charles T. Meyer, M.D." wrote:
>
> > Ves,
> >
> > Since your brother has been diagnosed with PD has he been prescribed any
> > Haldol?  Please be more specific about what , when and how much he took
of
> > the different medications.  I think that if you can provide us that
> > information there are a number of us on the list  that would venture an
> > opinion on whether his medication regimen has been or is being less than
> > optimally managed (or frankly mismanaged).
> >
> > Charlie
> >
> > ---- Original Message -----
> > From: ves <[log in to unmask]>
> > To: <[log in to unmask]>
> > Sent: Sunday, January 23, 2000 9:13 PM
> > Subject: improper meds?
> >
> > > My brother has parkinsons and I think has been
> > > mis-medicated(?).
> > > Reasons for this suspicion:
> > > 1.  Has been on sinement for about 7 years.
> > > 2.  Has been being previously medicated with Haldol.
> > > 3.  More recently medicated with Risperdal and Ativan.
> > > I understand sinemet can have delayed symptoms as well as a
> > > reduced affect with prolonged use.
> > > I also understand from the parkinsons drug database that the
> > > meds in items 2 and 3 can have some negative effects with
> > > parkinsons patients.
> > > He is in the hospital in Electra Texas and the doctor really
> > > does not want to take into account these pieces of
> > > information I have told her of.  Any PK patients around
> > > wichita falls or vernon texas who might refer me to some
> > > kind of second opinion that is an informed second opinion on
> > > meds for PK patients?
> > >
> > > ves shirley
> > > 336-342-3641
> > > I will accept collect calls.
> > > I really need some quick feedback.
>