If you live with Parkinson’s disease (PD) and experience pain, you are not alone. Chronic pain is twice as common among people with PD as it is in people without it. In fact, more than 80 percent of people with PD report experiencing pain and many say it’s their most troubling non-motor symptom. Fortunately, there are many ways to manage pain in PD. As with other aspects of the disease, there’s no one-size-fits-all approach. The first step is to work with your healthcare team to understand what’s causing the pain and then work together to find the best treatment plan for you.

What Kinds of Pain Can Be Part of Parkinson’s?

At its simplest, pain means the body hurts. When a person feels pain, nerves in the skin, joints and organs alert the brain to the location of an injury. Researchers have found that in early PD, there are already changes in the way that the body detects and regulates pain. Pain is complex and can take many forms. In PD, pain tends to affect the side of the body where motor symptoms first appeared. If your PD started with a tremor in the right hand, you’re more likely to develop pain in the right shoulder, wrist or fingers. Here are a few common types.

Musculoskeletal pain

Musculoskeletal pain is experienced by up to 75 percent of people with PD and includes pain in the muscles, bones or skeleton. It is related to rigidity and decreased movement, and to arthritis. Many people with PD experience muscle cramps and tightness in the neck, spine and arms. Muscles may feel stiff or achy. Joint pain, especially in one shoulder, is also common. It’s not uncommon for people with PD to be diagnosed with frozen shoulder or rotator cuff problems, and even undergo surgery.

Dystonic pain

Do you have painful curling of your foot, toes or hands? This is dystonia, a painful muscle spasm. Up to 50 percent of people with PD experience this at some stage of the disease. Foot dystonia is one of the most common sources of dystonic pain in early PD. Severe, painful spasms also can occur in the neck, face or throat muscles. Dystonia may occur spontaneously or may be triggered by certain movements, but is very often experienced in the early morning. It can also be related to fluctuations in PD medications. Report dystonia to your doctor for evaluation or recommendations.

Neuropathic pain

Also called radicular pain, neuropathic pain occurs when a nerve is crushed or inflamed. Between five and 30 percent of people with PD experience neuropathic pain. It feels sharp, electric, tingling or like coolness or numbness. In people with PD, changes in posture, as well as dystonia, can cause nerves to be crushed. A common type is sciatica - lower back pain that extends down one leg. People with PD may also experience peripheral neuropathy - injury to nerve endings that begins with numbness in the toes or fingertips.

Central pain

Central pain affects about 10 percent of people with PD at some point. It can be difficult to describe but may include a vague, constant boring sensation; abdominal pain, reflux, shortness of breath or feeling flushed; painful sensations around the mouth, genital or rectal areas or simply “pain all over.”

Treating Pain

How can you make a specialized plan for your PD pain? Build a team that includes a PD doctor, nurse, physical therapist, occupational therapist, pain management specialist and in some cases, an orthopedic specialist.

Optimize PD Medications

It’s critical to ensure your PD medications are working optimally. Your doctor may want to examine you immediately before and after you take PD medications. To increase, decrease or change your medication to extend its effectiveness.

Exercise and Physical Therapy

Exercise is beneficial, particularly for musculoskeletal pain, but it can be a catch-22. It may be difficult to exercise when you’re in pain, but if you’re in pain and you stop moving, it gets worse! A physical therapist can recommend exercises or techniques to target the source of your pain. For example, if you experience neuropathic pain, the physical therapist can help improve your posture, which may alleviate pain.

Other Medications

Your doctor can prescribe medications that target specific sources of pain. For example, muscle relaxants can help dystonia, as can deep brain stimulation (DBS) and botulinum toxin (Botox®). Medications for epilepsy and depression, such as gabapentin (Neurontin®) or nortriptyline (Pamelor®) may be helpful for neuropathic and central pain. Anti-inflammatory medications like ibuprofen may ease musculoskeletal pain.

Treat Depression and Other Health Conditions

Chronic pain and depression are intertwined. If a person experiences depression, it may worsen pain and other PD symptoms. In addition, people who are depressed have a hard time taking medications properly, and this sets a vicious cycle in motion: with missed doses, medications don’t work well, and a person feels worse. Treating depression is essential for managing pain. It’s also important to treat other health conditions, such as osteoporosis or diabetes, that impact pain.

Self-Management for Pain

If pain begins suddenly or an injury occurs, it is considered acute, especially if there is swelling or bruising. Apply cold packs for 15-10 minutes several times daily for the first 48-72 hours. Elevate the area to decrease swelling.

If pain is long lasting (chronic), apply heat to the area for 15-20 minutes. Purchase a microwaveable hot pack that conforms to the area (or make your own with rice in a tube sock knotted at the opening). Heat pack according to directions; heat rice-filled sock for approximately two minutes in microwave.

If muscles feel tense or “knotted,” try self massage. Apply pressure to the area with a tennis ball, using your body weight against it for deeper pressure. Knobby plastic massage tools or a Theracane can be used to get better leverage on hard-to-reach areas. An appointment with a massage therapist may also be helpful.

Involving Your Team

When pain lasts longer than two weeks, interferes with sleep, or intensifies, it’s time to involve your team. Keep track of WHEN the pain started, WHERE it hurts, HOW long it lasts and WHAT it feels like (achy, sharp). It will be useful to also track when the pain starts in relation to when you take your medication. This information will help your healthcare team work more efficiently with you in designing a treatment plan.

Road to Recovery

Pain in PD is often overlooked and can have a significant impact on quality of life. The good news is that it can be managed. Tell your doctor about your pain so you can figure out what kind it is and find the best solutions for it. Once a cause is determined, you and your team can choose therapies that best fit your individual needs so you can feel your best.

We all need to do the things that make life meaningful and keep us independent, whether in our work, hobbies, social life or in simply taking care of ourselves. But maintaining these activities can be especially challenging for people who live with Parkinson’s disease (PD). One of the best resources for people in this situation is occupational therapy (OT), which is designed to improve your ability to take on the activities you value and to be the person you want to be. Here is an overview of how OT can help.

What Is Occupational Therapy?

In life with PD, you may have encountered speech or physical therapists. Where does occupational therapy fit in and how is it different? First, note that the word “occupation” in OT means “activity.” Our job in OT is to identify strategies that will allow you to continue doing activities that are important to you. Each person with PD will have different goals based on his or her symptoms and disease progression, as well as individual lifestyles, interests and priorities. Whether you have been living with PD for one month, five years or 20 years, and whether your goal is playing tennis or spending time with family, our approach is the same: to find ways to match your personal strengths with activities and an environment that will help you reach your goal.

Be Your Own Therapist

Which activities are most important to you? Once you answer, try the strategies below to see which ones work for you for each activity.

Use your personal strengths.

How can you build on your strengths and minimize your limitations? For example, if you have the strength of helping children enjoy reading, you could exercise that strength by reading to your grandchildren, by listening to them as they read, or by playing a reading game that stimulates both your imagination and theirs.

One of your strengths may be thinking skills. One thinking skill is imagining doing the activity before doing it. For example, imagining writing big can actually help you write big. Another thinking skill is speaking the steps out loud. When combing your hair, try saying “hold and comb,” to avoid dropping the comb.

Make sure you are exercising. Improving strength, balance and endurance through exercise supports your participation in all sorts of activities. Whether it is dancing or walking to a neighbor’s house, find an enjoyable way to exercise.

Lastly, be positive. Think, “I will do…” rather than “I’ll try to…” and you may be more successful.

Change the environment.

How can you adapt your surroundings to support your chosen activity? For example, will it help to choose a different physical or social setting for the activity, or to use different objects and tools? Take a look at your environment. Create a quiet space with conveniently arranged furniture to make activities easier. Look into adaptive devices such as a tub seat to make showering safer or a swivel seat cushion in the car to make getting in and out easier. Additionally, think about the social environment and choose places where people will understand your needs.

Adapt the activity.

Which activities do you enjoy and how can you adapt that activity to make sure you can still do it? For example, if you love baking, perhaps substitute complex recipes with simpler ones.

To get started, write down your goals or say them aloud to yourself or to someone else. Then ask, are there ways to simplify or modify the activity? For example, if you love golfing with friends, but now find it challenging, ask yourself if it is just the golf you enjoy or if it is the socializing that goes with it? Based on your answer, can you meet your friends for coffee or a drink after they finish their round? Can you play nine holes instead of 18? Can you use the golf cart instead of walking the course?

Lastly, focus on one activity at a time. Parkinson’s can make it difficult to multitask. If someone is talking to you while you are eating, tell him or her that you will continue the conversation as soon as you finish your meal.

Find an Occupational Therapist

Are you looking for a more personalized plan? If so, request a referral for occupational therapy from your neurologist or movement disorder specialist. Ask them if they can recommend an occupational therapist with knowledge of PD. You can also contact your state OT association, or local rehabilitation facility or home care agency, to find an OT. You can find more information on the American Occupational Therapy Association website at www.aota.org.

Conclusion: Stay Engaged

People with PD can and should keep doing the activities they love to do. If PD symptoms get in the way, an occupational therapist can help. Together, you will set realistic goals, identify challenges and strategize solutions. Identify what is important to you and figure out a way to continue doing it. Find the “sweet spot” where your strengths, the activity and environment work together and then go for it.

Tip: Enhancing Hand Coordination

We use our hands throughout the day in all activities. People with PD may notice changes in the ease in which they perform hand and finger motions. An occupational therapist can help evaluate and make recommendations to improve hand coordination:

• Exercise hands and fingers regularly
• Engage in enjoyable and stimulating hand exercises, such as gardening or knitting
• Use toothbrushes, hairbrushes, silverware and writing tools with larger handles
• Use both hands in tasks - don’t favor one hand over the other
• Schedule tasks that require greater hand control for times when you are well rested and medications are working well

A balanced diet is a foundation of good health. For people with Parkinson’s disease (PD), a balanced diet is even more important. In PD, there are some foods that may help to ease symptoms and help brain health, while others can affect the way medications work. While there are many things about PD that cannot be changed, the informed choice of diet can help people to live better with the disease.

Foods That Promote Brain Health

In the science of brain health, we often use the word neuroprotection: the process by which we can support the health of brain cells and their ability to communicate with one another. Over the years, various food groups have been studied in animals and in large epidemiological studies of human populations for their potential to promote brain health. Initial research has provided some evidence about possible benefits of certain foods. Although there isn’t yet evidence about the specific benefits for Parkinson’s disease, what we do know is that these foods are part of a healthy diet.

Neuroprotection

Of all the foods that have been studied for their potential to promote brain health, research into nuts and herbs has shown promise. Here is what we know.

• Walnuts. Walnuts contain an essential fatty acid called omega 3 and a variety of minerals, which early studies associate with a decreased risk for dementia. Try eating five to 10 each day.
• Pistachios. Emerging evidence shows these nuts (the vitamin K and antioxidants in them) may have potential for helping to reestablish lost connections between neurons. They also contain a small amount of lithium, which may help to improve mood. You can eat a few of them two or three times a week.
• Macadamia nuts. Oils in these nuts may increase the production of neurotransmitters that help brain cells communicate with each other. They are high in calories, but a few a day is good for you.
• Cashews. Iron, zinc and magnesium in cashews may boost serotonin — a neurotransmitter linked to good mood — and may reduce memory loss.
• Almonds. Although they have little effect on brain health, almonds contain fiber, which helps relieve constipation (a common symptom in PD).
• Brazil nuts. These nuts contain selenium, a mineral that may have the potential to counteract environmental toxins like pesticides and herbicides. Eat no more than one or two a day.
• Turmeric. This spice turns Indian food orange, and its active ingredient is curcumin. Add tumeric to food, but don’t take it as a supplement.
• Ceylon cinnamon. In animal studies, this spice has shown potential for normalizing neurotransmitter levels and other PD brain changes. Look for Ceylon cinnamon, which is grown in Sri Lanka and labeled as such. Organic cinnamon is also preferable.

Anti-Inflammatory Foods

Fighting inflammation can be another important strategy for keeping the brain healthy. The types of fats you consume may play a role in reducing inflammation in the body, and those known as “medium-chain triglycerides” may be particularly helpful. Coconut oil contains this fat. You can cook with it just as you would with olive oil. Other anti-inflammatory foods include rosemary, oily fish, like salmon, tuna and mackerel, dark leafy green vegetables, like kale, collard greens and spinach and soy products.

Benefits of Purple and Red

Foods that contain antioxidants may also protect brain health. Antioxidants counteract molecules known as “free radicals,” which can damage healthy cells including neurons. Fruits that are purple and red, like blueberries and raspberries, contain pigments called anthocyanins, which are well-known antioxidants. Some studies suggest that drinking green tea (three cups a day) is neuroprotective, because EGCG, found in green tea, is both an anti-inflammatory agent and an antioxidant.

Foods for PD Symptoms

Nutrition adjustments can help ease some of PD’s most common symptoms, both of a motor and a non-motor nature. If you experience digestive difficulties, especially constipation (which is very common in PD), try to drink more fluids, and increase your fiber intake with fruits and vegetables such as kiwi, apples, prunes, dates, figs, radishes, berries, nuts and beans. Probiotic supplements like Bifidobacterium (B. breve, B. adolentis and B. infantis), that add healthy bacteria to the gut, may also be helpful.

If drinking more water leads to urinary incontinence or urgency, increase your fluid intake by eating foods with a high water content such as tomato, cucumber, radish, celery, broccoli and grapefruit. If you struggle with weight loss or loss of appetite, try increasing your calorie intake by eating nuts and foods that contain healthy fats, like coconut and avocado. To stimulate your appetite, try bitter greens like collard and beet greens, or spicy foods. Exercise can increase muscle mass and hunger.

Fatigue and sleep difficulties are also common symptoms of PD. The culprit of these problems may be sugar. When eaten during the day, sweets briefly boost energy, but make you sleepy later. When eaten in the evening, they may keep you awake.

Another reason to limit sugar is that it causes a spike in blood glucose, which contributes to inflammation. When reaching for a snack, try foods that offer a balance of protein and fat, like nuts or avocado, or whole-grain complex carbohydrates, like brown rice and quinoa.

How Foods Affect PD Medication

Another benefit of dietary changes can be improvement in the effectiveness of PD medications. Taking medications at mealtime can affect how quickly they are absorbed into your system, and the rate at which your body uses, or metabolizes them. If you take carbidopa/levodopa (Sinemet) for PD symptoms, you may find that protein-rich foods such as meat, fish, eggs or dairy products, or high-fat foods, lengthen the time it takes for the medicine to kick in, or make the medication less effective.

The solution? Talk to your doctor about taking levodopa 30-60 minutes before a meal or 1-2 hours after finishing a meal. Be aware that high-protein and high-fat snacks can also interfere with levodopa. Your doctor or a nutritionist can give advice on how to schedule the protein you eat, to avoid having it interfere with levodopa.

Conclusion

People with PD need to eat a balanced diet in order to feel their best and maintain energy. Eating more nuts and berries, cutting back on fried food and sweets, and cooking with herbs are all elements of sound nutrition and they may also help you manage your PD.

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Many people with Parkinson’s disease (PD) experience motor fluctuations as part of their disease progression. Motor fluctuations are changes in the ability to move and are also referred to as “on-off” times. When Parkinson’s medications (levodopa and dopamine agonists) begin to take effect, you experience periods of good symptom control, called “on” time, when you can move and function well. As levodopa begins to lose its effect, known as “wearing off,” you may have periods where symptoms are suddenly much more noticeable and movement becomes more difficult, known as “off” time. Sometimes, people experience involuntary movements (dyskinesias) when medication levels are at their highest point. These variations throughout the day are known as motor fluctuations.

Why Do Motor Fluctuations Happen?

As Parkinson’s disease progresses, it is common for more dopamine-producing brain cells to die, causing the benefits from Parkinson’s medications to not last as long as they did before. The brain eventually reaches a point where it stops producing dopamine in large amounts and therefore must rely on medicine to replace dopamine. Researchers think this happens for two reasons:

• As Parkinson's progresses, cells become less able to store dopamine. When this occurs, the cells are unable to release dopamine without medications, such as levodopa. When the dose fades, 60-90 minutes after taking it, there is no more levodopa for the cells to use, resulting in lower dopamine levels and a worsening of symptoms (“off” times).
• The cells in your brain become more sensitive to both higher and lower concentrations of levodopa. There is a higher likelihood of experiencing “off” times when levodopa levels are too low and a higher likelihood of experiencing dyskinesis (involuntary movements) when levodopa levels are too high.

As a result, your doctor may advise you increase your medication doses to achieve optimal control of motor symptoms, such as tremor, slowness and rigidity. The goal is to maximize symptom control without increasing side effects.

Non-motor fluctuations

Many non-motor symptoms can also be affected by “off” time. Non-motor symptoms are Parkinson’s symptoms that are not related to movement, such as mood, cognition or fatigue. Mood fluctuations are particularly common and are often experienced as a general state of dissatisfaction with life, irritability, depression, or anxiety. If you notice a relationship between mood changes and the timing of your PD medication, tell your neurologist. He or she might be able to adjust your dopamine replacement medications or dose to reduce “off” time, which may help your mood. Many people experience anxiety as their anti-Parkinson’s medications wear off, near the end of the dosing cycle. If you or someone close to you notices a pattern of anxiety associated with “on-off” fluctuations, talk to your neurologist about adjusting your medications. Psychotherapy can also be helpful in this situation. If there is a pattern of “off”-state anxiety, a therapist can help you learn to anticipate the anxiety and cope with it through relaxation techniques and other cognitive behavioral strategies.

Treating "On-off" fluctuations

The goal of managing motor fluctuations and dyskinesias is to help you remain as active and independent as possible. Depending on your current medications, there are several approaches your doctor can take to help smoothen your response to medications to minimize or avoid fluctuations. Your doctor may:

• Adjust the dose of levodopa, either by increasing the dose or adjusting the frequency
• Add different medications to your current regimen to help keep levels of dopamine more consistent to avoid “off” time. Examples are COMT inhibitors, dopamine agonists, or MAO-B inhibitors.
• Try a controlled-release or extended-release formulation of carbidopa-levodopa, designed to extend the benefits from the same dose of carbidopa-levodopa and possibly decrease the number of pills needed per day.
• Bring up surgical options, like deep brain stimulation or Duopa therapy. Read our book, Surgical Options, for more information on various surgical techniques used to treat PD at Parkinson.org/Library.

Other Common Issues

In addition to a return of PD symptoms and onset of dyskinesia, some people experience dystonia and/or freezing with motor fluctuations.

Dystonia is when muscles continuously contract, causing parts of the body to twist or curl. Dystonia may occur at peak dose, when the medication is working at its best. More commonly, dystonia occurs when dopamine levels are the lowest (“off” periods) or when medications are just starting to kick in.

“Freezing” is the temporary and involuntary inability to move. If freezing happens when the next dose of medication is due, it is called “off” freezing.

Medications Management of Motor Fluctuations

Usually, freezing episodes decrease after taking medication. Different medications are available to treat “off” episodes, including:

Levodopa: Changing how you take Levodopa can impact off episodes.

Dopamine Agonists: Stimulating the parts of the brain that are influenced by dopamine, the brain is tricked into thinking it is receiving the dopamine it needs.

• Apomorphine Hydrochloride Injection (APOKYN®)

Amantadine: Used in early and advanced PD to help tremor. It can also be useful in reducing dyskinesias that occur with dopamine medication.

• Amantadine ER capsules (Gocovri) Amantadine ER tablets (Osmolex ER)

Adenosine A2a antagonists: Can reduce “off” time by 30-60 minutes per day without worsening dyskinesia. However, dyskinesia can still be a side effect.

• Istradefylline (NOURIANZ™)

COMT Inhibitors: This class of PD medications has no direct effect on PD symptoms, but prolongs the effect of levodopa by blocking its metabolism.

• Entacapone (Comtan®)
• Tolcapone (Tasmar®)
• Opicapone (Ongentys®)
• Carbidopa/levodopa/entacapone tablets (Stalevo)

MAO-B Inhibitors: By blocking the MAO-B enzyme, which breaks down dopamine, this makes more dopamine available to the brain.

• Selegiline (l-deprenyl, Eldepryl), (Zelapar)
• Rasagiline (Azilect®), Safinamide (Xadago)
• Safinamide (Xadago)

Parkinson’s disease (PD) has both motor and non-motor symptoms. Among the nonmotor symptoms of PD are cognitive changes, constipation, sleep issues and mood disorders. Some non-motor symptoms may improve with an adjustment to your Parkinson's medication. Exercise, dietary modifications, psychotherapy and other supportive therapies are also key to managing the non-motor symptoms of PD. In addition, there are medications available to help address these symptoms.

There is no standard treatment for Parkinson’s disease (PD). Instead, treatment is individualized to each person’s specific symptoms. There are many medications available to manage PD movement symptoms and it is common for people with Parkinson’s to take a variety of these at different doses and at different times of day. Medication is only part of the overall treatment plan for PD. Exercise, physical and occupational therapy, as well as lifestyle changes are also key to living well with Parkinson’s.

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Below is a list of recommended questions to help you prepare for your upcoming doctor’s visit. Based on your personal priorities, think ahead of time about what questions you want to discuss with your doctor.

1. How quickly does Parkinson’s disease usually progress and what will change over time?
2. How is Parkinson’s treated? Are there ways I can slow the progression of my Parkinson’s?
3. What test(s) or tools did you use to determine my diagnosis?
4. How often should I make appointments, and should I expect to see you or another staff member at each visit?
5. What other specialists or healthcare professionals should help me manage my care?
6. What symptoms or side effects should I report immediately?
7. How and when should I take my medication? Should I take the medicine before, with, or between meals?
8. What are the potential side effects of medication? Is there anything I can do to avoid or manage the side effects that I might experience
9. Besides taking medications, what else can I do to manage my Parkinson’s disease? Are there specific therapies, exercises, or lifestyle changes that can help?
10. Are there any clinical trials I could participate in?

Get more of your questions answered today: Visit Parkinson.org/NewlyDiagnosed or contact the Helpline at 1-800-4PD-INFO (1-800-473-4636).

For people with Parkinson’s disease (PD), managing the disease often comes down to a daily balance of dopamine — the neurotransmitter that is lost in PD. The challenge is to work with dopamine replacement therapies to find the right levels of dopamine. Dopamine medications have improved life for millions of people, but researchers believe that some people with PD on these medications can develop impulse control disorders (ICDs) — unhealthy levels of gambling, shopping, eating and sexual activity.

What are Impulse Control Disorders?

An impulse control disorder is the inability to stop doing something that is harmful, or could become harmful, to yourself or others. Performing the harmful activity is believed to relieve anxiety and tension.

How Common are Impulse Control Disorders?

Scientists have known for over a decade that dopamine-related drugs for Parkinson’s could be linked to ICDs in some patients. However, it was not until 2004 that people living with Parkinson’s began to learn that ICDs could be a rare side effect of dopamine agonists. Today, we know that one in six people taking dopamine agonists will experience impulse control disorders.

How Serious are Impulse Control Disorders?

For some people, ICDs may be mild, or just a minor nuisance (for example, increased focus on eating sweets). For others, the impact may be more severe. People who experience compulsive gambling and compulsive shopping may lose large sums of money, even to the point of bankruptcy. Those who binge eat may experience significant weight gain, causing discomfort and embarrassment and possibly increasing vascular disease risk factors. Some of those who experience compulsive sexual behaviors may begin engaging in unprotected sex or sex outside of an established relationship, placing themselves and others at risk physically and emotionally. ICDs typically impact not only the person living with PD, but loved ones as well.

What should I do if I suspect I have an ICD?

• Keep a drug diary and record changes in your mood or behavior, as well as physical responses.
• If you find yourself starting to engage in any of the behaviors listed above or doing things that you feel guilty doing, talk to someone about it. A support group member, your doctor or someone from your place of worship are potential resources.
• Let your family know what is happening, because the problem affects them too. ICDs could be a significant stressor on a marriage.

If the doctor determines that you have a medication-induced ICD and the medications in question are dopamine agonists or monoamine oxidase (MAO) inhibitors (ex. Pramipaxole, Ropinirole, Rasagiline, Rotigotine patch), the doctor can work with you to reduce your dosage or switch to another medication.

ICDs usually subside for people who clearly did not experience the ICD previous to that time and developed it in the context of taking a dopamine replacement therapy for Parkinson’s. There is a much smaller subset of people for whom ICDs persist despite the discontinuation of medications. There is another subset of individuals for whom going off a medication is not an option. Perhaps their Parkinson’s symptoms are too severe, or they are receiving psychological benefit from the medication. These individuals have other options. People who have significant motor fluctuations and have lived with PD for several years may be candidates for deep brain stimulation (DBS) surgery. Since a person can typically decrease his or her medications after DBS, this often will ease his or her ICD. A few other strategies have been explored, such as use of antidepressants, but there is little evidence at this point of their efficacy. Scientists are also investigating novel treatments to resolve ICDs but the evidence on these strategies is limited at this point.

Should people with Parkinson’s be concerned about their risk of developing ICDs?

It is now confirmed that dopamine agonists are associated with impulse control disorders. Data from the U.S. Food and Drug Administration and many other sources support this association. The large incidence (1:6) of impulse control disorders has been strongly associated with the use of dopamine agonists and should prompt practitioners to warn patients and family members about these issues. Remember, an impulse control disorder may be pleasurable, and therefore patients may hide the issue from friends and family. A prospective monitoring plan should be initiated along with the dopamine agonist therapy. The safest plans involve spouses, caregivers and friends who can provide feedback on any change in behavior directly to the prescribing physician. Remember, a person with Parkinson’s must consent to a prospective monitoring plan is necessary before implementation.

Call our Helpline for more information at 1-800-4PD-INFO (473-4636).

Este video es de la lista de reproducción de la conferencia, “Hacia adelante: Navegando el mar del Parkinson.”

Presentador

Xavier Cagigas, PhD, UCLA