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> Current Science Reviews       by Joe Bruman       June 1996 (part 2 of 4)
> Goetz C et al; Neur 1995;45:669-671:
> PD patients in nursing homes are more likely to have hallucinations and die sooner than those in community dwellings.
>
> Tison F et al; Neur 1995;45:705-708:
> Among 4050 elderly people surveyed, dementia was 8 times more likely in> PD patients living at home, and even more likely in those that were
> institutionalized.

To the group:
A possible explanation for hallucinations and PD (or so-called "PD") in
nursing homes may lie in medications. I enclose a page from my last
newsletter on drugs that mimic PD. I have the references, should anyone
care to see them. There are many reasons why I always ask my clients if
they use any medications, side effects like the following are among
them:

        YOU AND YOUR DOCTOR
        This month a family practitioner talks about Parkinson's
disease. Dr. William J. Thieman, M.D., has been a family practitioner
for 15 years. He understands and treats the health needs of older
adults, including hypertension, diabetes, arthritis and impotence.

        IS IT REALLY PARKINSON'S DISEASE? Parkinson's disease is a
disorder that results from damage to the brain. Doctors don't yet know
what causes it, but the signs of Parkinson's disease include trembling
in the arm, hand, or leg; rigid posture;  and unbalanced, shuffling
walk. As the disease progresses, there may be shaking of the head and a
stooped posture. Everyday activities, like bathing and dressing, become
difficult to perform.
        Now, the National Institute on Aging reports on medications that
may produce symptoms like Parkinson's disease. Researchers have found
that several commonly-prescribed drugs can produce effects that are much
like Parkinson's--so similar, in fact, that some people have been
wrongly diagnosed with Parkinson's disease.
        For example, sometimes people have nausea or vomiting during
cancer treatment. The drug Reglan (metoclopramide) is often prescribed
to prevent this stomach upset, allowing the patient to eat normally.
Reglan may also be used for heartburn.
        Although Reglan is a useful medication, some older adults
experience reactions, especially if they use it for a long time, or use
large doses.Undesirable reactions to Reglan include rigidity, trembling,
or mask-like faces.
        Doctors may believe the patient has Parkinson's, and begin
prescribing drugs for Parkinson's disease. Certain tranquilizers taken
for nervous disorders can also cause Parkinson-like symptoms in some
older adults.
        The National Institute on Aging cautions older adults to be
aware of possible side effects of these and other drugs. If you or
someone you know begins to have symptoms after starting a new
medication, it's important to let your doctors know.
         Your family doctor can be very helpful in dealing with other
specialists. You must tell your family doctor about all the medications
you receive from other physicians. And it's important to explain the
symptoms you experience.
        New and better medications are being developed each year,
providing relief from Parkinson's disease, and other illnesses. However,
older adults are more likely than younger persons to experience
undesirable reactions from drugs. Your doctor wants to choose the
medication that's best for you. So it's important to work closely
together.
        Be extra alert to side effects when starting any new medication.
It helps to inform those near to you--a spouse, a neighbor, a loved
one--so that they can be on the lookout for unusual behavior, too. And
it may help to bring that person with you when you go to the doctor.
Sometimes a second person can bring a different perspective or
explanation.
        Always be sure your family doctor knows of any new symptoms you
have after starting a new medication. Together, you can find a treatment
that's best for you.
--
Kathrynne Holden, MS, RD
Editor-in-Chief,
"Spotlight on Food--nutrition news for people 60-plus"
Tel: 970-493-6532   Fax: 970-493-6538
http://www.fortnet.org/~fivstar
Contact  Better Business Bureau of the Mountain States,
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