Expert: Eric Brandt - 12/2/2008

Question
"if my father is 60 years old and he has tremors and stifness. he is on sinemet but his symptoms return before the next doese. he has apathetic and sadness, poor apetite and constipation, he has trouble falling asleep and wakes up early because he is worried. he has blurry vision and he kicks and turns when he sleeps. he has restless leg syndrome and BPH. his mother has alzherms and his father had colon cancer. he lost 10 pounds in 6 weeks. he is taking terazosin, ferrous sulfate, pyridoxine and he is on sinemet 25/100 tid. i was wondering should we increase his sinemet dose to 25/250 and can you explain why or why not. thank you"

Answer
Hi John,
Apathy, sadness and constipation are not reversible with Sinemet. Sinemet will help with the tremors ans movement difficulties associated with Parkinson's. Try to increase the frequency of the dosing to 4 times a day and time the dosing to be taken 1/2 hour before the wearing off is anticipated. Your father may need an antidepressant. This is common in Parkinson's. We often use citalopram in these situations. Laxatives will help with the constipation. Parkinson's is a progressive degenerative disease. We can not stop it. We can only slow the progression.
Thank you for using Allexperts
Sincerely,
Eric Brandt, B.Sc. Pharm