Recognizing Changing Symptoms In Parkinson’s Disease May Help Patients To Better Manage Their Condition

Recognizing Changing Symptoms In Parkinson’s Disease May Help Patients To Better Manage Their Condition

Parkinson’s disease (PD) affects about 1 million people in the United States and 50,000 new cases are diagnosed each year. As researchers learn more about the disease, improved treatment options are possible.

That’s good news for people like Paul Ramirez, a World War II veteran and avid dancer. He was first diagnosed with Parkinson’s disease in 1999, after his wife saw him shuffling his feet during their daily neighborhood walks. Like many people with PD, Ramirez was treated with a traditional levodopa medication to manage his symptoms.

Levodopa is the most widely used symptomatic PD treatment and has remained the “gold standard” of care for nearly 40 years. The majority of people with PD eventually need levodopa treatment to control their symptoms, even if they begin their therapy with other medications. After several years of treatment with levodopa, however, people with PD may see changes in the way their medication controls their symptoms. Symptoms may return before it is time for the next dose of medication.

For Ramirez, the change in duration of his symptom control became increasingly noticeable after the first two to three years of levodopa treatment. Not only did he find that the onset of daily symptoms was becoming less predictable, he also found that his “off” time was increasing, meaning his motor symptoms, like freezing and slowness of movement, lasted for longer periods of time during each day.

Since Ramirez’s PD symptoms were not controlled as long as they could be, he needed to use a walker in order to maintain his balance, which severely limited his ability to participate in the activities that he enjoyed.

“I love to dance, but within a few years of being diagnosed with Parkinson’s disease, I found that I not only couldn’t dance, but many times I was even too weak to walk. It was very frustrating,” says Ramirez.

The change in symptom control that he experienced is called “wearing off.” Symptoms associated with levodopa therapy “wearing off” can include both motor and nonmotor symptoms. Motor symptoms may include trembling or shaking and nonmotor symptoms may include anxiety or feeling restless. When levodopa medication “wears off,” it can make even basic daily activities, such as walking and dressing, difficult for the person with Parkinson’s disease.

Ramirez’s doctor, Kevin Callerame, M.D., staff Adult Neurologist at the NeuroMedical Center in Baton Rouge, La., says, “The good news is that the motor symptoms of ‘wearing off’ can be treated with newer levodopa medications that can help increase the time levodopa controls the symptoms of Parkinson’s disease.”

When Dr. Callerame saw him in the summer of 2004, the physician noticed that he would have frequent freezing episodes.

Dr. Callerame began treating Ramirez with a Parkinson’s disease medication called Stalevo® (carbidopa, levodopa and entacapone). Stalevo is an enhanced levodopa medication that combines levodopa with two other components to reduce its side effects and extend its benefits. Stalevo tablets are indicated for certain PD patients who have levodopa-related “wearing off” motor complications.

In the year since Ramirez’s medication has changed, Dr. Callerame says, “Ramirez’s symptoms have been controlled for four to five hours, versus one to two hours, following each dose of Stalevo.” For Ramirez, longer symptom control has enabled him to walk more easily, and that has given him the confidence to try other activities that he once enjoyed.

Dr. Callerame urges people with Parkinson’s disease to communicate openly with their doctors because different treatment options may be available. However, in order to treat “wearing off,” it must first be identified.

A new, free-of-charge information and resource kit is available for people with Parkinson’s disease that can help to identify the signs and symptoms of “wearing off.” The kit contains a diary card to track when symptoms come back between doses of medication.

To order a free StEP Kit, call 1-866-STEP-KIT (1-866-783-7548) toll-free or visit www.stepkit.net.

Ramirez’s story represents the successful treatment with Stalevo (carbidopa, levodopa and entacapone) of an actual patient with Parkinson’s disease and experiencing “wearing off.” Because every patient responds differently, results may vary. In a clinical trial, Stalevo provided, on average, 1.4 more hours a day of symptom relief than standard levodopa.

Recognizing the signs and symptoms of “wearing off” can help you manage your Parkinson’s disease symptoms.

Important Information for Patients Regarding Stalevo®: Stalevo® (carbidopa, levodopa and entacapone) tablets are indicated for patients with Parkinson’s disease (PD). Stalevo is a medicine that can be used instead of carbidopa/levodopa and Comtan® (entacapone) by patients taking those medicines as separate tablets. Depending on levodopa dose and side effects, Stalevo can also be used to replace carbidopa/levodopa when the benefits of levodopa are wearing off. Please ask your health care professional if Stalevo is appropriate for you. Stalevo is supplied as tablets in three strengths: Stalevo 50, containing 12.5 mg carbidopa, 50 mg levodopa and 200 mg entacapone; Stalevo 100, containing 25 mg carbidopa, 100 mg levodopa and 200 mg entacapone; and Stalevo 150, containing 37.5 mg carbidopa, 150 mg levodopa and 200 mg entacapone. The most common side effects of Stalevo are unwanted or uncontrollable movements (known as dyskinesia); nausea; diarrhea; excessive muscle movements (known as hyperkinesia); harmless discoloration of urine, sweat and/or saliva; diminished or slow movements (known as hypokinesia); abdominal pain; dizziness; constipation; fatigue; pain; and hallucinations. Some of the more serious side effects may include severe diarrhea, severe dyskinesia, hallucinations, other mental disturbances, orthostatic hypotension (low blood pressure), rhabdomyolysis (a muscle disease), and symptoms resembling neuroleptic malignant syndrome (a condition characterized by fever and muscle stiffness). Tell your health care professional if you have bothersome side effects. He or she can make adjustments that may reduce these effects. You should not quickly lower your Stalevo dose or suddenly stop it altogether. Drugs broken down by the COMT enzyme (e.g., isoproterenol, epinephrine) should be used with caution when taking Stalevo. If you take a nonselective monoamine oxidase (MAO) inhibitor, you should not take Stalevo. Stalevo should not be taken with selegiline at doses higher than 10 mg/day. Because Stalevo contains entacapone, it should not be taken together with Comtan. Be careful using Stalevo if you have severe heart or lung disease; asthma; renal, hepatic or endocrine disease; or a history of heart attacks or ulcers. Do not take Stalevo if you have glaucoma, melanoma or other related medical disorders. Before you take Stalevo, talk to your doctor about any health problems you might have.

New Treatment For Parkinson’s Disease Individuals

New Treatment For Parkinson’s Condition Individuals

In the USA, an approximated 1.5 million Americans are afflicted with Parkinson’s condition (PD), with more than 60,000 new cases diagnosed yearly. While the condition normally creates after the age of 65, 40 percent of people detected are under age 60. Parkinson’s illness is a chronic, modern disorder of the main nerve system that comes from a team of conditions called motor system disorders. It impacts almost equivalent numbers of males and females, without evident social, ethnic, financial or geographical limits. There currently is no treatment for the disease, as well as the cause is unknown.

Levodopa/carbidopa is generally used very early in the treatment of Parkinson’s condition, yet as the illness proceeds it ends up being significantly hard to effectively control signs with this medicine. As a matter of fact, Parkinson’s condition patients may experience lots of hrs during the day in which their signs return as an outcome of medicine wearing away. This subsiding is called “off” time.

The bright side is that the U.S. Fda (FDA) authorized Zelapar ® (selegiline HCl) Orally Degenerating Tablets, a once-daily complement treatment for Parkinson’s condition clients being treated with levodopa/carbidopa that exhibit damage in the quality of their feedback to this therapy. Using a distinct by mouth liquifying medicine delivery system, Zelapar has been shown to decrease “off” time, typically, by greater than 2 hrs each day.

Marketed by Valeant Pharmaceuticals International, Zelapar is a selective as well as irreparable monoamine oxidase type-B (MAO-B) inhibitor and is the very first Parkinson’s disease treatment to make use of an unique delivery system called Zydis ® Modern technology, which permits the oral tablets to liquify within seconds in the mouth as well as provide more active medicine at a reduced dosage.

” Numerous individuals with Parkinson’s disease are not effectively managed on their existing treatments,” claimed Cheryl Waters, M.D., F.R.C.P. (C), Albert B. and also Judith L. Glickman professor, Department of Neurology, Columbia University. “The distinct formula of Zelapar enables the orally degenerating tablets to dissolve within secs. By delivering extra active medication at a reduced dose, Zelapar dramatically decreases ‘off’ time, giving important hrs back to the person.”

A brand-new drug is supplying increased advantage for Parkinson’s condition patients-helping lower “off” time, when symptoms are not effectively controlled.

Note to Editors: Important Safety Details

Zelapar is contraindicated in people with a recognized hypersensitivity to any kind of solution of selegiline or any one of the non-active active ingredients of Zelapar. Major, occasionally fatal reactions have been precipitated with the concomitant use of meperidine (e.g. Demerol ® as well as other tradenames) as well as MAO inhibitors consisting of selective MAO-B inhibitors. These responses have actually been characterized by coma, extreme high blood pressure or hypotension, serious respiratory anxiety, convulsions, malignant hyperpyrexia, excitation, peripheral vascular collapse and fatality. Furthermore, the mix of MAO preventions and dextromethorphan has been reported to cause brief episodes of psychosis or unusual behavior. Serious toxicity has actually likewise been reported in clients obtaining the mix of tricyclic antidepressants as well as conventional selegiline and careful serotonin reuptake inhibitors and also conventional selegiline. Zelapar needs to not be administered in addition to other selegiline products.

Zelapar might potentiate the dopaminergic negative effects of levodopa as well as might trigger or intensify preexisting dyskinesia. Decreasing the dosage of levodopa might boost this side result.

5.2 percent of people terminated Zelapar treatment due to negative events (vs. one percent with sugar pill). One of the most typical adverse events reported by clients treated with Zelapar were comparable to placebo, and also included: queasiness (11%), wooziness (11%), pain (8%), migraine (7%), insomnia (7%), rhinitis (7%), dyskinesia (6%), skin disorders (6%), stomatitis (5%), neck and back pain (5%) and dyspepsia (5%). Zelapar must be used throughout pregnancy just if the potential benefit to the mommy validates the potential danger to the fetus.