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Lori Bauer wrote: = > My grandmother was diagnosed with PD approximately 7 years ago. She ju= st > began Valium last week. = Dear Lori, There are some possible drug interactions between Sinemet and Valium: Drug interactions report for the following 2 medications: Diazepam (Valium=AE, Valrelease=99, Dizac=99) Levodopa; Carbidopa (Sinemet=AE) Levodopa; Carbidopa/Diazepam Patients receiving levodopa for Parkinson's disease experienced an exacerbation of parkinsonian symptoms when benzodiazepines were added to their regimen. Benzodiazepines should be administered cautiously to such patients. Some possible adverse effects regarding Valium alone: Abrupt discontinuation of diazepam after prolonged use can cause seizures in susceptible patients. Benzodiazepine withdrawal causes irritability, nervousness, and insomnia. Benzodiazepine withdrawal is more likely to occur following abrupt cessation after excessive or prolonged doses, but it can occur following the discontinuance of therapeutic doses administered for as few as 1=972 weeks. Benzodiazepine withdrawal is also more severe if the agent involved has a relative shorter duration of action. Abdominal cramps, confusion, depression, perceptual disturbances, sweating, nausea, vomiting, parasthesias, photophobia, hyperacusis, tachycardia, and trembling also occur during benzodiazepine withdrawal, but their incidence is less frequent. Convulsions, hallucinations, delirium, and paranoia also can occur. Benzodiazepines should be withdrawn cautiously and gradually, using a very gradual dosage-tapering schedule. Diazepam is usually chosen as the agent for controlled tapering in all cases of benzodiazepine withdrawal. The clearance and/or elimination of many drugs are reduced in the elderly. Delayed elimination can either intensify or prolong the actions of adverse reactions of the drug. Benzodiazepines have been associated with falls in the elderly and the consumer advocate group, Public Citizen, has recommended these drugs not be used in the elderly. > Over the last week she seems fatigued and > lethargic. This whole fiasco began when I mentioned to the nurses at t= he > nursing home that she was depressed. A psychiatrist was called in. He= > prescribed zyprexa (anti-psychotic), buspar (anti-anxiety) and remeron > (anti-depressant). All of this resulted in a trip to the emergency roo= m. I couldn't find information on zyprexa, and little on remeron. Possible adverse effects for buspar are: The most common adverse reactions occurring during therapy with buspirone are CNS effects such as dizziness (occurring in about 12% of patients), drowsiness (10%), headache (6%), and nausea/vomiting (6=978%).= Some patients exhibited a syndrome of restlessness with nervousness (5%) and excitement (2%). Less common adverse events occurring more frequently in buspirone treated patients than in placebo receiving patients include anger/hostility, confusion, blurred vision, myalgia, numbness, paresthesias, incoordination, tremor, weakness and diaphoresis. In premarketing assessment adverse events were recorded by over 3500 patients. A causal relationship has not been established. The most frequently reported adverse events, occurring in more than 1% of patients were nonspecific chest pain, nightmares, tinnitus, sore throat, and nasal congestion. > She was so completely disoriented and hallucinating they didn't know wh= at > to do! = The next thing I > knew, the psychiatrist had called back and put her on the valium. I'm > just trying to hang in there until next week when she goes to her first= > neuro appointment. I'm hoping he can take over most of the meds and ge= t > her straightened out. I think it would be better to have just one > physician handling the medication if possible. I agree, Lori, and preferably a neurologist specializing in movement disorders, or else a geriatrician. Either will be much better equipped to deal with these problems. And, very often, a pharmacist can help you interpret and sort out all these confusing factors. I'll be hoping for a good outcome for your grandmother following the neuro appointment. My very best regards to you and your grandmother, Kathrynne -- = Kathrynne Holden, MS, RD Editor-in-Chief, "Spotlight on Food--nutrition news for people 60-plus" http://www.fortnet.org/~fivstar and NUTRITION TOPICS copy-ready handouts http://www.dietetics.com/class/fivstar/ Tel: 970-493-6532 Fax: 970-493-6538