Detecting Parkinson’s Disease
VCU School of Pharmacy faculty, alumni and students have provided the Dr. Rx column for Richmond’s Fifty Plus magazine since December 2009. We now share those columns on the SOP website, as well, for those who might not have seen the most recent issue.
Serving as Dr. Rx for April 2016 was Agneta Liubinaite, a fourth-year Pharm.D. student. She holds a bachelor’s degree in clinical laboratory sciences from the VCU School of Allied Health Professions. Her areas of interest include geriatrics, ambulatory care and community pharmacy.
I heard that the first and only symptom of Parkinson’s disease is a tremor. Is that true?
A. About 1 percent of Americans older than 65 and 3 percent older than 80 suffer from Parkinson’s disease (PD). This is the second most common neurodegenerative disorder after Alzheimer’s disease.
Even though Parkinson’s is not as common as other chronic health conditions in the United States, Americans are living longer; therefore, it is important to be aware of this disorder. With an increase in the older adult population, the prevalence of certain health conditions is projected to increase as well.
PD is a central nervous system disorder, where certain parts of the brain are dysfunctional. In the case of PD, there is a decrease in production of dopamine, a signaling messenger that plays an important role in movement, learning, attention and pleasure.
The exact cause of PD is unknown, but several theories exist. Known risk factors for PD include older age, male gender, family history of PD, exposure to environmental toxins (such as smoking), genetic factors and head trauma.
PD is a slowly progressing disease, and symptoms will vary from person to person. To answer your question, tremor may be the first and only symptom of PD for some patients, while others never develop a tremor. It is also important to keep in mind that symptoms may change and worsen over time.
Classic symptoms of PD include:
- Tremor: shaking, usually in the hand when it is at rest
- Rigidity: stiffness of the arms or legs
- Akinesia: lack of movement or slow movement
- Postural instability: difficulty with balance
Additionally, people with Parkinson’s disease may experience changes in mood, memory and sleep. Tremor and other symptoms may be associated with other health conditions, as well, so it is important to get an accurate diagnosis.
There is no known cure for PD, but there are medications that help manage PD symptoms. These medications include dopamine (e.g., carbidopa and levodopa), dopamine agonists (e.g., pramipexole), MAO-B inhibitors (e.g., selegiline), anticholinergics (e.g., benztropine) and amantadine. In order to manage symptoms of PD effectively, timing of medications is critical.
Even though treatments for PD have been shown to be safe and effective, there are side effects associated with these medications. These side effects may make coping with PD even more difficult. Some medications, such as antipsychotics or certain over-the-counter medications, may cause drug-drug interactions with PD treatment. Therefore, it is important to talk to your pharmacist or physician to avoid any drug-drug interactions.
It is also important to remember that managing PD requires a team approach. Patients may work with physicians, pharmacists, physical therapists, speech therapists, psychologists and others. Some patients also may be candidates for a surgical intervention known as deep brain stimulation.
Here are few sources to help you learn more about PD and management of PD:
- Parkinson’s Disease Foundation provides helpful information about management of PD and the latest research information.
- National Parkinson’s Foundation provides free kits for people with PD. The kit includes a hospital action plan, identification bracelet, medication form, “I have PD” reminder slips and a PD fact sheet.
- Local PD support groups. Connecting to local support groups may help you to share similar experiences and cope with diagnosis if you have been diagnosed yourself or if you take care of a loved one who has been diagnosed with PD.