Expert Tips and Interviews on Living with Parkinson's Disease
ParkinsonSecret_Header_01.jpg

Hot Topics in Parkinson’s Disease

Michael Okun Indu Subramanian Jonny Acheson

 

If You Have Parkinson and are Dizzy or Passing Out, There is Likely a Treatment

-Many Parkinson’s disease (PD) patients visit the emergency room or clinic because of dizziness and or syncope also known as passing out

-In most cases it is not the heart or the ears causing the problem

-The condition is called orthostatic hypotension

-It is a manifestation of Parkinson’s disease (autonomic nervous system involvement) and is often worsened by Parkinson’s medications

-Sometimes antihypertensive medication must be stopped in a Parkinson's disease patient, but this is tricky and the decision should always involve a consultation between a neurologists and a general doctor

-Dopaminergic medications (particularly the dopamine agonists) have been documented to worsen this condition

-One treatment is increasing fluid intake, increasing dietary salt and caffeine, and using tight, thigh-high support stockings

-Raising the head of a normal bed 10-30 degrees may improve the condition 

-Fludrocortisone 0.1 mg once daily or Midodrine 5-10 mg three times per day may help

-Ephedrine 25-50 mg q4-6 hours and phenylpropanolamine start 25 mg twice per day are rarely used because of risks

-Mestinon and Midodrine are drugs that have been tried

-Droxidopa, L-threo-3,4,-dihydroxyphenylserine is a new drug that is currently in clinical trials for treatment of this condition

  

Michael Okun