Seroquel

Anonymous
Posted: Tue Aug 18, 2009 11:29 pm Post subject: Seroquel

I seem to remember postings on Seroquel -- its pluses and minuses. But I can't locate them. Any comment, doctors? Seroquel has been prescribed for me because I've been hallucinating. The dose is one .25 mg tablet at bedtime. Anonymous
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Sat Aug 22, 2009 8:30 am Post subject:

Quetiapine (seroquel) is one of our first line treatment for hallucinations in PD. It is generally well tolerated. Because of this, it is often also used for other conditions such as insomnia, and agitation. However, just like any drug, it has its share of side effects. It can cause sedation (that is why it is given at night and used for insomnia as well), confusion, lightheadedness, and rarely, it can worsen PD, but not usually. Yours,_________________Hubert H. Fernandez

Progression of PD

Anonymous
Posted: Tue Aug 18, 2009 9:36 am Post subject: Progression.

There is a PwP in our area who has had Parkinson's for at least 18 years and it does not seem to have progressed at all.He is still on Mirapex and a small amount of Sinemet at night. Is it possible that on rare occassions Parkinson's does stop progressing or that the progression is so slow it hardly notices?Thank you
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Dr. FernandezJoined: 20 Jan 2007Posts: 90
Posted: Tue Aug 18, 2009 10:06 pm Post subject:

Definitely, the progression in PD is a very individual thing. Some of our patients progress so slowly that we hardly see a difference from year to year. Some patients are more devastated by the illness and we see a change whenever they visit us in clinic. And the majority of patients fall in between these two extremes. Of course, there is a possibility that your neighbor does not have PD but a mimicker of PD...? Yours,_________________Hubert H. Fernandez

Risk of Stroke and Parkinson's

Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Fri Aug 07, 2009 4:21 pm Post subject: Post of the Week: Risk of Stroke and Parkinson's

Despite potential issues with the methods in this study from Switzerland it is interesting that when examining a large database two issues emerged: 1- Risk of PD diagnosis was increased if a previous stroke, 2- the risk of first time ischemic stroke was increased in PD. These findings will need to be confirmed, but raise the possibility of some association of PD and stroke. Parkinsonism Relat Disord. 2009 Jul 27. [Epub ahead of print]Links Risk of stroke in patients with idiopathic Parkinson disease. Becker C, Jick SS, Meier CR. Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Switzerland. PURPOSE: Large population based studies on the association of Parkinson disease (PD) with stroke are scarce. This study aimed to quantify the risk of a first-time diagnosis of idiopathic PD in patients with a history of stroke, and to assess incidence rates for stroke in PD patients. METHODS: We used the UK-based General Practice Research Database to compare the prevalence of stroke/TIA in newly diagnosed PD patients and in a matched comparison group without PD between 1994 and 2005. We conducted a follow-up study with a nested case-control analysis to quantify the risk of incident stroke/TIA in relation to a previous PD diagnosis. RESULTS: A history of stroke/TIA was associated with a significantly increased relative risk of being diagnosed with PD compared to patients without such a history (adj. odds ratio [OR] 1.65, 95% confidence intervals [CI] 1.47-2.00). In the cohort study, the crude incidence rate ratios (IRRs) for incident hemorrhagic stroke, ischemic stroke or TIA were 0.66 (95% CI 0.26-1.72), 1.46 (95% CI 1.03-2.07) and 1.86 (95% CI 1.40-2.47), respectively. CONCLUSIONS: In this large observational study the risk of a PD diagnosis was significantly increased after a previous stroke event, as was the risk of a first-time ischemic stroke in newly diagnosed PD patients compared to persons free of PD._________________Michael S. Okun, M.D.

Having depression before your diagnosis of PD affects QOL

Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Wed Aug 05, 2009 12:12 pm Post subject: Having depression before your diagnosis of PD affects QOL

Dear forum members, The relationship between depression and quality of life in PD has been something we feel is deserving of more research. A small study was recently published commenting on this relationship. Interestingly, if you had depression prior to your PD diagnosis it may affect your quality of life (QOL) post diagnosis (or be related to it). The abstract is below: Parkinsonism Relat Disord. 2009 Jul 27. [Epub ahead of print]Links Impact of pre-morbid depression on health-related quality of life in non-demented Parkinson's disease patients. Klepac N, Hajnšek S, Trkulja V. Department of Neurology, University Hospital Centre Zagreb, Zagreb University School of Medicine, Kispatićeva 12, Zagreb, Croatia. The need to understand and improve health-related quality of life (Hr-QoL) in Parkinson's disease (PD) has been emphasized. In order to investigate contributions of depression that existed before the onset of typical motor symptoms ("pre-PD depression"), idiopathic non-demented non-psychotic patients with (n = 32) and without (n = 120) a history of pre-PD depression, free of relevant comorbidity, calliper-matched for age, education and disease duration were evaluated for motor and non-motor disease aspects and Hr-QoL (Parkinson's Disease Questionnaire 39, PDQ-39). History of pre-PD depression was independently associated with higher actual levels of depression and anxiety, poorer sleep quality and mental set shifting, which all contributed to poorer Hr-QoL. Mediation analysis demonstrated significant indirect effects (mediated through the effects on mood/emotion/sleep and/or cognition) of pre-PD depression on PDQ summary index and subscales, but also direct (non-mediated) effects on emotional well-being and body discomfort subscales independent of the sociodemographic, motor/non-motor disease or treatment-related characteristics. Data indicate that for a given level of motor/non-motor PD symptoms severity, history of pre-PD depression contributes to poorer Hr-QoL._________________Michael S. Okun, M.D.

Melatonin

nonymous
Posted: Wed Aug 12, 2009 7:54 pm Post subject: melatonin

Is the use of a otc sleep aid containing melatonin harmful to a person with Parkinsons?Back to top


Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Thu Aug 13, 2009 5:35 pm Post subject:

I am not aware of this being harmful. I also do not think this is the best sleep aid in PD. Make sure you report this to your doctor and get a specific sleep disorder diagnosis and have he/she tailor the therapy. Some people say melatonin is good for jet-lag!_________________Michael S. Okun, M.D.

Ask the question

http://www.patientslikeme.com/forum/show/51124

Can people really be "cured" from Parkinson's?

http://www.patientslikeme.com/forum/show/50951

NPF Discussion:denture and excess saliva

People with dentures have excess saliva as dentures are foreign substances in the mouth and the mouth produces excess saliva as a reaction perhaps treating the dentures as food


Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Fri Aug 07, 2009 3:35 pm Post subject:

Thanks for the comment. Also remember botox and anticholinergics can dry you up but may also lead to cavities!_________________Michael S. Okun, M.D.

There are complaint by the parkinson's patient to the doctor the drooling saliva and dentures
Therefore Movement disorder specialist deal with medication to minimise the effect of saliva on the patient.
They classified the excess of saliva is the slow saliva swallowing by PD neither the cause the saliva on dentures
The dentist classified the saliva developing dentures slippery and loose is a gap develop between the denture and the gummy ridge.

.
Therefore the denture may need repeated relines. Shrinkage of the bone and gums can be minimized or prevented with a proven technique

Dr. Okun Joined: 19 Jan 2007 Posts: 251 Location: University of Florida

Posted: Sun Aug 09, 2009 8:39 pm Post subject: Thanks for the added comment. _________________ Michael S. Okun, M.D.

Are they difference?

Anonymous	Posted: Tue Aug 04, 2009 5:30 am Post subject: Leg freezing Are there differences? Does Up/down stair or cycling cause leg freezing? Does Sitting, walking and standing cause leg freezing? Kindly elaborate
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Dr. Okun Joined: 19 Jan 2007 Posts: 251 Location: University of Florida	Posted: Tue Aug 04, 2009 8:58 pm Post subject: There is no rhyme or reason why some people freeze and some people do not? Why some people respond to cueing and some do not? Why some people's freezing responds to meds and some does not? These are million dollar questions and we need more research to unlock their answers. One potential answer is that PD is not one disease, and that there are many causes and variations....I know not very satisfying! _________________ Michael S. Okun, M.D.

patientlikeme: dentures and saliva

http://www.patientslikeme.com/forum/show/50312

symptoms of Leg freezing

Parkinson patients experience symptoms of freezing as follows

l. stop suddenly while walking

2. beginning to initiate walking and unable to move forward

3. stuck to the ground but the body still wants to move on

4. doing activities:

stepping off after rising from sitting,beginning to speak; when raising
a cup to drink; or starting to get out of bed.

Freezing, which is often preceded by frequent
and small shuffling steps (festination), can also
lead to problems with balance. This increases
the risk of falling and makes freezing a
potential dangerous symptom of Parkinson’s.

PNF Forum:Leg Freezing

teokimhoe Joined: 03 Mar 2007 Posts: 150 Location: Malaysia	Posted: Sat Jul 25, 2009 8:02 am Post subject: Leg Freezing When you have leg freezing whilst walking instead going forward going backward to prevent a fall. Holding both leg and slap side of both knees to release the freezing Stay horizon the place where you are to release the freezing. The reason why you have leg freezing because you are under medication and it is wearing off. It is strange why the parkinson patient does not have leg freezing problem whilst on cycling? Is it we walking we concentrate our movement to balanc? Is it cycling we paddle up and down with one leg after the other? _________________ to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
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Rogerstar1 Joined: 14 Mar 2007 Posts: 421	Posted: Sat Jul 25, 2009 10:36 am Post subject: It has been my experience that at least in the early years one's voluntary movements (typing, throwing a ball etc.) are affected most during 'off' periods. Autonomic movements like breathing, ducking to avoid or blocking a ball thrown at your face by instinct, moving a leg forward or back to maintain equilibrium and 'break' or prevent a fall are involuntary and hindered only after lengthy disease progression. Thus. willing myself to step off a curb or into a closed hallway or room is sometimes a problem if 'off'. Catching a fall by moving a leg to balance is still mostly an automatic reaction that I simply ...do. But, alas...that ability is slipping away, too. Best to you Tee-Man. Rogerstar
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bernard shaw Joined: 19 Aug 2008 Posts: 323 Location: Austria Late UK	Posted: Sun Jul 26, 2009 12:42 pm Post subject: Bern Leg movements. I too have these stupid periods where one leg will suddenly stop right in the middle of a step. I have used a walking stick for the last twenty five years and I am sure that it is the stick that stops me falling flat on my face. My last fall nearly a year ago I not only broke the little finger of my right hand but had to undergo an hours operation to fix the break and put the finger lesion back into place and five stitches to close the wound. Painful to say the least. I wish you much luck with your medication, my Neurologist increased my sinemet retard 200/50 by one extra tablet since then the leg movements are better. Keep smiling best regards from Bern _________________ If your face wants to smile, Let it. If it doesn't, Make it.
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Patientslikeme:Compementary & Alernative therapy

http://www.patientslikeme.com/forum/show/50239

patientlikeme: denture do not last forever

http://www.patientslikeme.com/forum/show/50240

NPF Forum:dental do not last forever

http://forum.parkinson.org/forum/viewtopic.php?t=7854

NPF Discussion:dental and saliva

Anonymous
Posted: Fri Jul 31, 2009 8:39 am Post subject: denture and saliva

There are complaint by parkinson's patient how to deal with saliva and dentures. The saliva causes the dentures slippery and loose even there are denture paste if a gap develops between the denture and the gummy ridge Therefore the denture may need repeated relines. Shrinkage of the bone and gums can be minimized or prevented with a proven technique
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Fri Jul 31, 2009 11:13 am Post subject:

This can be a troublesome issue. If you dry the saliva too much with an anticholinergic drug or botox you can also get cavities. I would suggest you work with the doctor to find the right solution for you, but to brush your remaining teeth frequently if you dry the saliva._________________Michael S. Okun

I just read about the Dr. saying that the looseness is caused by bone shirinking.

Four years ago I paid a lot of money for new dentures that many trips back to the denturist never made comfortable. New dentures were finally made and in just a few months I had to go back to have something done to them as they were very loose. I was told that access saliva was the cause,and that parkinson saliva had something that prevented adhesives from working. A spray from the drug store was to be used and nothing was done to the dentures. I am back to square one. If your Dr. is right I should have them lined -----right?

Anonymous
Posted: Sun Aug 02, 2009 8:39 pm Post subject:

You will find comfortable without dentures as your saliva easy to swallow.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Mon Aug 03, 2009 7:05 pm Post subject:

Thanks for the comment. Comfort I have found is patient specific!_________________Michael S. Okun, M.D.

People with dentures have excess saliva as dentures are foreignsubstances in the mouth and the mouth produces excess saliva as a reaction perhaps treating the dentures as food'

Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Fri Aug 07, 2009 3:35 pm Post subject:

Thanks for the comment. Also remember botox and anticholinergics can dry you up but may also lead to cavities!_________________Michael S. Okun, M.D.