Apathy the cause of Parkinson's Progression?

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Anonymous
Posted: Fri Sep 28, 2007 5:45 pm Post subject: Apathy the cause of progression of Parkinson's ?

Dear Doctor, I refer to the above articles. One of the cause for his apathy to Parkinson's is as follows: Is it the physiological changes or adaptation to disability and cognition in relation to disability, mood , personality? Kindly elaborate Thanks TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Sep 30, 2007 10:54 am Post subject:

Apathy is quite common in PD. We are still researching the cause. The mood and apathy changes in each patient are quite individual and they need to be addressed in a patient specific manner by each doctor._________________Michael S. Okun, M.D.
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Anonymous
Posted: Sun Sep 30, 2007 7:28 pm Post subject: Apathy the cause of Parkinson's progression/

Depression is common in Parkinson's disease and is associated with reduced cognitive performance and quality of life. depression and dementia, but not motor symptoms, were associated with increased mortality in Parkinson's disease depression and cognitive impairment were associated with impaired functional ability, in addition to psychosis, age, duration of Parkinson's disease, apathy, sleepiness and motor impairment. Treatment of dopamine agonists or levodapa AR not associated with apathy in the Parkinson's progression. As the result the mood and apathy changes in each patient are quite individual that delaying the treatment as some doctors are not in the field. Therefore apathy the cause of Parkinson's progression' Kindly elaborate' TEOKIMHOE
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Anonymous
Posted: Mon Oct 01, 2007 8:11 am Post subject: Apathy the cause of Parkinson's progression/

Dear Doctor, My brother is Parkinson's for the past of three years' During his early stage Parkinson's he does not stays ahead of the changes of his bodies. Furthermore,he is stubborn to take medications as he is in tolerate with disaffect of PD medication. He has the trainer and was told not to come after two weeks and the trainer does not continue his session He has so far 5 trainers and resigning 1 or 2 weeks. They find him he is problematic except the new trainer Robin Chew who has 2 years training wit physiology Is it the physiological changes or adaptation to disability and cognition in relation to disability, mood , personality? He could not tolerate the medicine and he is at 1/2 dose of Madopar. TEOKIMHOE
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Tue Oct 02, 2007 8:02 pm Post subject:

I am sorry, Teo, but I do not understand your reasoning. Given all the information we have about apathy, I do not think that it is the cause of PD progression. First, apathy is only seen in 20-30% of PD patients, but PD progression is universal--meaning all PD patients progress--although some slower than others. Yours,_________________Hubert H. Fernandez
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Tue Oct 02, 2007 8:05 pm Post subject:

It is hard to tell, Teo. Human behavior is so complex. It could be, as you suspect a combination of factors. His irritability and difficult personality can be a manifestation of depression, it can be his way of screaming "help me", it can be his character's expression of frustration, etc. Clearly, if he is not optimized with medication, these behavioral effects will continue. Thus, it is important that the medication combination that works for him and that he tolerates is found soon. Yours,_________________Hubert H. Fernandez
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Anonymous
Posted: Wed Oct 03, 2007 10:08 am Post subject: Apathy the cause of Parkinson's progression?

Dear Doctor, As my brother has a difficult personality and his irritability with Parkinson's that made him emotional disorders i.e. depression, anxiety and frustration. He stays mostly alone at home therefore the only way of screaming "help me" is his character's expression of depression. Besides he has nobody to talk to and he is trying runaway from reality and helplessness i.e fear of unknown and the search for a "cure" As he in tolerates with the medicines the doctor prescribed him 1 1/2 dose of Madopar and 1 1/2 doses Lexinor daily. The doctor finds difficulty to optimize medication and could not change his way of behaviour of "screaming i.e the side effect of his medications. The trainers in tolerate with his attitudes and cooperation and resigning one by one. At present he has one trainer with him. He spend time with him and encourages him to be positive in life and active in exercises. Why is it so complicate with him and to deal with? Do you agree managing and overcoming negative emotion is not easy especially the problematic Parkinson's patient? Should he seeks professional help? Best regards TEOKIMHOE
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Dr. RodriguezJoined: 22 Jan 2007Posts: 92Location: Gainesville, Fl
Posted: Thu Oct 04, 2007 6:27 am Post subject:

I think he will benefit from professional help. I wish him the best._________________Ramon L Rodriguez, MD
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Anonymous
Posted: Fri Oct 05, 2007 5:04 am Post subject: Apathy the cause of Parkinson's progression/

Dear Mr Teo I think your brother's problem is difficulty accepting his illness rather than apathy. One of the most challenging problems that any neurologist faces is patients difficulty in accepting illness. As a result, these patients do not really accept the doctor's advise, e.g. medication schedule (poor compliance). I treated a man with Young-Onset PD (onset of symptoms before the age of 40) recently. He was just 38 years old, and at such age it is just natural for him to have difficulty accepting his PD. When I treated him with Pramipexole, he insisted that he had felt slower and weaker despite the medication. And he said, "since I am not getting better with Parkinson's medications, it means that I have another illness and NOT PD" - which was his way of denying that he has PD. At one stage, he even stopped his medications as he did not believe he had PD. He even questioned my diagnosis of PD. It took me a long time to convince him to start taking Pramipexole again. Recently, I heard from his sister that he had continued taking Pramipexole - he had finally accepted his illness. Difficulty in accepting PD is largely due to ignorance and fear. I think it helps patients to accept their PD if we tell them that they can continue to have a relatively good quality of life as the treatment of PD has drastically improved over the past decade (due to new medications and brain surgery). Dr Chew Nee Kong, Kuala Lumpur. -------------------------------------------------------------------------------- Date: Wed, 3 Oct 2007 01:31:56 -0700
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Anonymous
Posted: Fri Oct 05, 2007 5:32 am Post subject:

Dear Dr. Chew, I fully agree with you my brother does not accept he has Parkinson's as he is still young. Therefore he stops taking the pd medication as he felt that it bought unnecessary side effects on him. He is total denial and unbelieved that he went to other medical field i.e. related with Parkinson's for treatment. As the result his Parkinson's is on progression without medication. It is too late to be normal and enjoy good quality lifestyle. TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Fri Oct 05, 2007 7:02 am Post subject:

Thank you for the beautiful post._________________Michael S. O


Anonymous
Posted: Mon Oct 08, 2007 4:36 pm Post subject: Apathy the cause of Parkinson's progression/

Dear Doctor, I fully aware that the early stage of PD patient does not accept that he has symptoms of PD even been diagnosed by doctors.. He treats it as an aging process as the result the patient end up with Parkinson's progression. Besides Parkinson's has symptoms with other related diseases and some doctors wrongly diagnosed as an age aging process. I am one of the sufferers. It takes me four years to be treated as Parkinson's patient. I am fortunate that my PD is slow progression.as I do daily exercises far ahead for changes of my body movement. The late Parkinson's treatment aggravated movement disorders further and could not to be normal and enjoy good quality life. Therefore a good start to tackling health issues is to understand the diseases themselves. As an early PD patient I experience emotional disorders - anxiety,depression, apathy, uncertainties and stress. : I have fear as follows:- When do I tell others, and what do I say? Whether to tell " is a question posed by many people in the early stage of PD disease. 1. Is it jeopardize my job? Don't let other people feel sorry for me and for my wife and children? 2. Keep it yourself as secret and privacy and once it reveals you feel sorry as you cannot take it back. 3. I feel relieve as I tell out and I could get some support. 4. It is hard to keep it secret as PD is a not ' going on "disease and the tension of hiding it. 5. It helps more people to aware the diseases and encourage more set up support group and seminars i.e fund raising for the poor patients and learn to manage and overcome the disease and feel you are not alone. I hope more patients would use this forum to share their experience how Parkinson's come to their lives and how to manage them with their lovers? Lord bless. TEO KIM HOE Back to top Best regards
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Mon Oct 08, 2007 7:51 pm Post subject:

The answers to your questions are really very personal and individual. There is no standard answer that will fit all. I think at this point it is best that you be followed closely by a good psychologist for counselling sessions. It sounds like you need psychotherapy in addition to pharmacotherapy. Yours,_________________Hubert H. Fernandez
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Anonymous
Posted: Thu Oct 11, 2007 4:03 am Post subject: Apathy the cause of Parkinson's progression?

Thank you for your suggestion. Be informed I have consulted the specialists concern and is going fine. Best regards TEOKIMHOE
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