Adjusting Parkinson's medication
After starting Parkinson’s drugs, your treatment regime will usually need adjusting over time as your symptoms change. Parkinson’s nurses Jennifer and Nicola explain more.
Parkinson’s medication can become less effective as your symptoms change over time. Every person with Parkinson’s is different. Your specialist or Parkinson’s nurse will work with you to find the best dose or combination of treatment so that your symptoms are as controlled as possible.
Considering other issues
Before increasing your medication, your specialist or Parkinson’s nurse will look at the bigger picture. For example, they may ask if you’re taking the correct dose at the correct time. Taking your medication at the same time every day will help you get the best control of your symptoms.
Constipation is common in Parkinson’s. If you experience this symptom, it may mean your body isn’t able to absorb your Parkinson’s medication properly, which can lead to your symptoms getting worse. Your diet can also affect how well your Parkinson’s medication is absorbed.
Maximum doses
All medications have a maximum dose and if your medication is increased, you may worry about reaching this limit.
When you’re diagnosed with Parkinson’s, your specialist or Parkinson’s nurse will discuss the advantages and disadvantages of starting medication with you. If you have very mild symptoms, you may decide together to wait until symptoms become more difficult. But if your symptoms are impacting your daily life, they may recommend you start medication.
People also have their own tolerance levels of the medication. Tolerance is how well you respond to a drug over time.
Planning a medication routine is something that should be a joint decision between you and your healthcare professional.
As your symptoms change, your healthcare professional will consider both what the maximum dose of a drug is and how well you’ve tolerated the medication so far.
It’s important to remember that even if you reach the maximum dose of a medication, there are other options. For example, there are different medications that could be added to your treatment regime and can work alongside your existing medication to help you manage symptoms.
There are also advanced therapies, such as apomorphine and duodopa, that can be used when pills no longer work well enough to control Parkinson’s symptoms on their own.
Side effects
If you experience side effects from the medication you’re taking, such as involuntary movements (dyskinesia) or hallucinations and delusions, your healthcare professional may consider reducing the medication you’re taking. This is more likely with advanced Parkinson’s when side effects can outweigh the benefits of taking medication.
You should always tell your specialist or Parkinson’s nurse straight away if you experience any side effects from the medication you’re taking. Don’t stop taking or change the dose or timing of your Parkinson’s drugs until you have spoken to your health professional, as this can increase your symptoms.
Reviewing your medication
If your medication dose is adjusted or you’re prescribed a new medication, your specialist or Parkinson’s nurse will usually review your medication 2 to 4 weeks later.
Working with your healthcare team
Planning a medication routine is something that should be a joint decision between you and your healthcare professional.
Before changing your dose, your specialist or Parkinson’s nurse should always explain things clearly and tell you anything important about the drug, such as possible side effects.
Always ask them if there’s anything you don’t understand or any symptoms you’re particularly worried about. They won’t mind – communication between you and your healthcare team is key.