Can't shake your Parkinson's fatigue: Living with Parkinson's Tip of the Day

One of the most common issues (encountered by person’s with Parkinson’s disease) is fatigue.

Where should you start? Consider a couple of tips…

·      Fatigue may result from medications or cocktails of medications. Some of these medications may not be Parkinson’s disease related.

·      Sleepiness can sometimes result from high dosages of Sinemet or Madopar. Sometimes lowering the dose or using a CR can curb sleepiness or fatigue.

·      A sleep study may reveal the reason for underlying fatigue. Too many people wait and keep putting off the sleep study. I am a big advocate to do the sleep study early and to see a sleep specialist early in the course of fatigue. If you do not get a good night’s sleep you will not have a very good next day.

There are a few other tips I usually think about when I encounter fatigue. I look for sedating medications given at bedtime (e.g. clonazepam, seroquel, others) and I move the doses from bedtime to dinner-time. This will provide ample time for the medications to wear off and to not contribute to fatigue the next day. I also think about exercise as that can be activating; in many cases starting the day with exercise or alternatively exercising for short periods throughout a day can be useful. Finally, untreated depression or mild depressive symptoms can result in fatigue. A low dose of a SSRI or SNRI in these cases may be helpful.

“I’ve discovered that as the years go by, sometimes we are energized and enlightened and sometimes we are demoralized and disheartened to realize that in some situations our beginning is our end and in others our end is our beginning.” — Martin Guevara Urbina

Read more in the new book by Dr. Okun, Living with Parkinson’s (Robert Rose, 2020).