 |
 |
Greetings: This article was scanned with Robin Elliott's permission from:=20 PARKINSON'S DISEASE FOUNDATION NEWSLETTER - WINTER 1996-97 What Medications PD Drugs Go With [And Don=92t Go With) =20 Lucien Cote, MD, Professor of Neurology, Columbia University A common question among Parkinson's patients is this: what medications may I safely use along with my Parkinson medications? The answer is not cut and dried. Sure there are drugs that should never be used by someone who has PD, whether or not he or she is taking PD medications. But there is another group of medications that may be useful and appropriate for a Parkinson's patient. To be sure these are to be used safely, we reiterate our mantra: all Parkinson=92s patients should be under the care of a physician who is experienced with Parkinson's disease and the medications that are used to treat it. In urban areas, (and sometimes elsewhere), such a person can typically be found among neurologists who have made a specialty of movement disorders such as Parkinson's disease. With this qualification, here are some generalizations about=20 different groups of drugs and their connection with Parkinson's. This list includes the most frequently used medications, but may not be all-inclusive. For each we list the generic name first, followed, in parentheses, by the brand name or names corresponding to that generic.=20 Neuroleptic (antipsychotic) drugs. If you have any question about how the information on these medications, or any other that you may be taking, relates to you personally be sure to consult with your doctor! Most of the commonly prescribed medications in this category will worsen PD symptoms and should not be taken by a patient who has the disease--whether or not he or she is on Parkinson's medication. In this category are haloperidol (Haldol); thioridazine (Mellaril); molindone (Moban); thiothixene (Navane); pimozide (Orap), fluphenazine (Prolixin and Permitil); mesoridazine (Serentil); trifluoperazine (Stelazine); chlorprothixene (Taractan); chlorpromazine (Thorazine); acetophenazine (Tindal); perphenazine (Trilafon, Triavil and Etrafon); triflupromazine (Vesprin); and promazine (Sparine). The only antipsychotic drugs that may be taken safely by a PD patient are clozapine (Clozaril) and possibly olanzapine (Zyprexa). Antidepressants. One of these--amoxapine (Asendin)--may worsen Parkinson's disease symptoms. Two others--phenelzine (Nardil) and tranylcypromine (Parnate), that inhibit both forms of the brain enzyme monoamine oxidase ( type A and type B)--do not by themselves worsen Parkinson's symptoms but should never be used by patients who are taking levodopa (Sinemet). Selegeline. Selegeline hydrochloride (Eldepryl; Deprenyl; Jumex; Jumal), a mononoamine oxidase inhibitor (MAOI), is unique among drugs in its class in that its inhibitory impact is mainly on the "B" type of MAO. Because of this unique property,selegeline can be used with levodopa(Sinemet).However,several reports have appeared in the literature suggesting that a dangerous interaction may occur between selegetine and any antidepressant. For this reason, selegeline cannot be used for patients who are on antidepressants. Other Common Medications. Two drugs commonly prescribed for gastrointestinal disorders- prochlorperazine (Compazine) and thiethylperazine (Torecan)--cannot be used in patients with PD. A third drug in this category--metoclopramide (Reglan)--can be used under some circumstances but may worsen PD symptoms. Among medications used to reduce blood pressure, one-methyldopa (Aldomet)--may be given to patients who are on the Parkinson's drug levodopa (Sinemet) but only under the close supervision of their physicians. Because many Parkinson's patients are on multiple drugs to control their symptoms, they are especially vulnerable to interactions with other medications. Although the above list includes many of the most common adverse interactions facing a PD patient, it is not comprehensive. If you have any questions concerning a drug not listed, consult your doctor. PARKINSON'S DISEASE FOUNDATION William Black Medical Research Building Columbia-Presbyterian Medical Center 710 West 168th Street New York, N.Y. 10032 9982 Editor & Executive Director -ROBIN ELLIOTT=20 Scientific Editor - BLAIRFORD,M.D. 710 West 168th Street,NEW YORK,NY 10032-9982(212)923-4700 OR(800)457-6676 Margaret Tuchman([log in to unmask]) 55yrs/Dx 1980 -- NEW JERSEY - CD#12