Friends--- I asked the following question on Seroquel after reading the
package insert. The neuro who is the "Expert" on the NetWellness website
run by the U. of Cincinnati happend to be Peter's neuro ! I was curious
what he'd say, as he has put Peter on Seroquel, and it seems to be working
well for him.
Here are my (anonymous) question and his answer the next day:
Question:
The anti-psychotic, Seroquel, seems to help many
Parkinsonians who have hallucinations/confusion. But the
package insert lists PD as a reason NOT to take it. How
do you reconcile these two facts? Is it a matter of the size
of dose? Or interaction with PD medications? Is there a
maximum safe dose for Parkinsonians?
Answer:
All anti-psychotic medications block the D2 dopamine
receptor to some extent. As a result they can worsen the
symptoms of PD. However, Seroquel, like its
predecessor Clozaril is an `atypical narcoleptic` in that it
has greater effects on the D4 dopamine receptor. Thus, it
has the potential to relieve hallucinations without
significantly worsening PD symptoms. My own
experience with this drug in some 5-10 patients has been
quite satisfactory. Small pilot studies also indicate that it is
a useful addition to our armamentarium of drugs. It
certainly has a major advantage over Clozaril in that it
does not require weekly blood tests. However, unless a
large, randomized study convinces the FDA otherwise,
the package insert will continue to include the warning.
While, it can and should be used in this setting, its use
should be carefully supervised, preferably by a physician
trained in movement disorders.
For more information:
Arif Dalvi, M.D.
Assistant Professor
Department of Neurology
College of Medicine
University of Cincinnati
Only your personal physician,
pharmacist, nurse, or other health
professional you consult can best
advise you on matters of your
health based on your medical
history, your family medical history,
your medication history, and how
information from any of these
questions may apply to you.
The URL for the Ask an Expert section on PD is
http://www.netwellness.org/expert/expert_frame.htm
Give it a try!
Camilla Flintermann, CG for Peter 81/70/55
Oxford, Ohio
http://www.newcountry.nu/pd/members/camilla/one.htm
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"Ask me about the CARE list for
Caregivers of Parkinsonians ! "
