Thursday, May 14, 2009
depression , anxiety and insomina by Dr.Chew
As I had mentioned earlier, you have been more affected by the non-motor symptoms (insomnia, depression, anxiety) than the motor symptoms of Parkinson's. Overall, your motor symptoms are well controlled by a combination of effective medications, good exercise program and optimistic attitude.In fact, with the effective treatment for motor symptoms of Parkinson's (e.g. medications, brain surgery), I find that managing the non-motor symptoms is much more challenging. Depression and anxiety are very common in Parkinson's. Most of my patients are on sedative agents and anti-depressants. When I have difficulty managing these problems, I do refer these patients to the psychiatrists. Another common non-motor symptoms is insomnia. Most of my Parkinson's patients are on sleeping pills. I am quite liberal in prescribing sleeping pills for Parkinson's patients because I believe that good quality sleep is important in helping the body to rest and maintaining optimal level of physical activity. Apart from sleeping pills, we should also investigate the underlying causes of insomnia e.g. suboptimal control of motor symptoms at night, coexisting depression and anxiety, etc. As in your case, the following cocktail has help you to have a good quality of sleep;Stilnox (10 mg) 1/2 tablet - helps you to fall asleep quickly (within 15 minutes) and maintains sleep for at least 6 hours.Xanax (0.5 mg) 1/2 tablet - anti-anxiety medication which also helps you to fall asleep.Lexapro (10 mg) 1/2 tablet - anti-depressant and anti-anxiety medication. Seroquel (25 mg) 1/2 tablet - even though it is not approved by the FDA, this medication has been used to treat insomnia due to its sedative effect.Hope you will continue to do well with your medications.Dr Chew Nee Kong, Kuala Lumpur.