Chris F. Owen wrote:
> I would like to introduce my mother.  She just turned 80
> in May and was diagnosed with Parkinson's Disease in 1992.  Since
> '92, she has deteriorated physically fairly rapidly, losing weight and
> having difficulty with mobility and other problems.
>         She is currently taking Sinamet CR 200/50 @2 1/2 daily; Ritalin
> 10 mg. daily; and one aspirin daily.  In addition, she is also on heart
> medicine lanoxin and novotriamzide(sp?).  She's had one eye undergo cat=
aract
> surgery in April of this year and is scheduled for the other one this f=
all.
>         Her main problems at this time, apart from lack of appetite, ar=
e
> much dizziness,  difficulty with vison, (she can no longer read the
> newspaper), and excessive sleepiness, which she finds disconcerting, to
> say the least.
>         She has had a brain scan and there was nothing significant foun=
d
> and is scheduled to see an ear nose and throat specialist to examine he=
r
> ears to see if that might be the cause of her dizziness.  She has also
> seen an eye doctor who determined that there isn't anything significant=
ly
> wrong with her eyes.
>         Is there anybody who has either prior experience or knowledge a=
nd
> can give us any help as to what she can do to alleviate these symptoms?=
=20

Dear Chris,
I just got back in town to find your messages. I don't have prior=20
experience or knowledge, I am a registered dietitian. But anorexia (loss=20
of appetite), weight loss, and medications that can cause these=20
conditions concern dietitians.

I looked up the medications you mentioned, but could find nothing like=20
"novotriamzide"--perhaps it's spelled differently? I checked the other=20
ones, though, with the following results:

Ritalin--possible adverse reactions:
=95abdominal pain
=95agitation
=95angina
=95anorexia
=95anxiety
=95arthralgia
=95dizziness
=95drowsiness
=95exfoliative dermatitis
=95fever
=95headache
=95hypertension
=95hypotension
=95insomnia
=95nausea/vomiting
=95palpitations
=95psychosis
=95sinus tachycardia
=95urticaria
=95vasculitis
=95weakness
=95weight loss
=95withdrawal

You mention lack of appetite (Ritalin can cause anorexia), dizziness=20
(dizziness, hypotension), losing weight (weight loss), and I wonder if=20
these symptoms have begun since she started taking Ritalin. Drowsiness=20
can also occur.

Drugs that can interact with ritalin:

=9Canticholinergics
=9Cantihypertensive agents
=95bretylium
=95caffeine
=9Cdiuretics
=95dopamine
=95epinephrine
=9CMAOIs
=95phenytoin
=9Ctricyclic antidepressants
=95warfarin

Regarding lanoxin, under "Adverse reactions" I found:
=95anorexia
=95atrial tachycardia
=95AV block
=95blurred vision
=95confusion
=95constipation
=95diarrhea
=95drowsiness
=95fatigue
=95gynecomastia
=95headache
=95hyperkalemia
=95hypokalemia
=95impotence
=95libido decrease
=95nausea/vomiting
=95photophobia
=95PR prolongation
=95premature ventricular contractions (PVCs)
=95sinus bradycardia
=95ST-T wave changes
=95syncope
=95visual impairment
=95xanthopsia

I note here the anorexia, blurred vision, drowsiness, and visual=20
impairment--these seem to apply to your mother; there is a note that=20
lanoxin should be used with caution inthe elderly.

Under sinemet, the following are listed as=20
contraindications/precautions when taking sinemet:
=95cardiac arrhythmias
=95cardiac disease
=95closed-angle glaucoma
=95diabetes mellitus
=95hepatic disease
=95melanoma
=95peptic ulcer disease
=95psychosis
=95pulmonary disease
=95renal disease

Possible adverse reactions when taking Sinemet:
=95anorexia
=95ataxia
=95dystonia
=95flushing
=95hypertension
=95hyperventilation
=95involuntary movements
=95leukopenia
=95nausea/vomiting
=95neuroleptic malignant syndrome
=95orthostatic hypotension
=95polyuria
=95psychosis
=95tremor
=95urinary incontinence
=95urinary retention
=95weight loss

Again, we see anorexia, weight loss, with orthostatic hypotension.=20
Unusual tiredness is also possible with sinemet.=20

Chris, older adults often have different reactions to medications than=20
younger people do, as they cannot clear the drugs from their systems as=20
quickly. Her physicians must weigh her condition, age, diagnosis and=20
symptoms against possible side effects, and it's not an easy call. If=20
you think the meds may be taking a toll, I'd discuss it with her=20
doctors.

Let me know if this has been of any help.
Best regards,
--=20
Kathrynne Holden, MS, RD
Editor-in-Chief,
"Spotlight on Food--nutrition news for people 60-plus"
Tel: 970-493-6532   Fax: 970-493-6538=20
http://www.fortnet.org/~fivstar
You may wish to contact:
Better Business Bureau of the Mountain States,
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for further information.