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