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Parkinson's Disease board


I'm writing this for my dad who has diagnosed with Parkinson's at 81 years old (9 months ago). His Parkinson's progressed extremely rapidly. He doesn't have tremors, but he can barely walk (stiff, weak muscles) and he's starting to suffer from dementia.

My dad went into the hospital about 30 days ago, he developed pneumonia from aspirating on his food (he has trouble swallowing). It was touch and go there for awhile, but he was able to pull through. One of the "doctor's" there (I use that term loosely) has decided that my dad has undiagnosed bi-polar disease. He's put my dad on THREE neurological meds: Depakote which is an anti-convulstant, Abilify which is a mood-stabilizer, and Trazadone which is anti-depressant (this is along with 3 other meds for high-blood pressure).

This "doctor" is basing his diagnosis on dad's current mental condition. He's very emotional, crying at one point and then happy the next. I'm sure that this is largely due to his dementia (and I also wonder what all those neurological meds are doing to him). This "doctor" also uses dad's inability to sleep at night as an indication of "mania" (though he can sleep through the day). Hello? Even as a layperson I know that it's very common for someone suffering from Parkinson's disease to have problems sleeping at night.

All three of my dad's kids adamantly disagree with this doctor's diagnosis of "bi-polar", as well as my step-mom who's been married to him for over 10 years. This "doctor" told my step-mom that dad was able to hide his symptoms due to his intelligence and also due to the fact that my step-mom was a "stabilizing" influence. (Give me a break...if it was that easy to "hide" symptoms of bi-polar disorder, what the heck do we need any meds?).

My dad held the same job for over 50 years, my dad has never been depressed other than the normal type lows that everyone goes through in their lifetime. I've also never seen any sort of "mania" in all the years growing up with my dad. This doctor only met my dad when he was in the hospital suffering from dementia. How can he make this sort of diagnosis??? He's also a psychiatrist, not a psychologist. So he's never done any sort of psychological testing.

I don't know what to do to fight against this. My biggest concern are all the meds this idiot has my dad on. I don't know how these meds can effect Parkinson's???

My step-mom has power of attorney. Unfortunately she's of that generation that believes doctors are gods and are thus never wrong. I'm trying to fight for a second opinion. I'd like my dad to be seen by a geriatric specialist. Someone who must see a lot of dementia, a lot of Parkinsons, etc.

Does anyone know if the types of drugs I mention above can be harmful to someone with Parkinson's (especially this far advanced). And also, am I right the people with Parkinson's often times have problems sleeping at night?

Thanks so much...
Quote from AliAyson:
I'm writing this for my dad who has diagnosed with Parkinson's at 81 years old (9 months ago). His Parkinson's progressed extremely rapidly. He doesn't have tremors, but he can barely walk (stiff, weak muscles) and he's starting to suffer from dementia.

My dad went into the hospital about 30 days ago, he developed pneumonia from aspirating on his food (he has trouble swallowing). It was touch and go there for awhile, but he was able to pull through. One of the "doctor's" there (I use that term loosely) has decided that my dad has undiagnosed bi-polar disease. He's put my dad on THREE neurological meds: Depakote which is an anti-convulstant, Abilify which is a mood-stabilizer, and Trazadone which is anti-depressant (this is along with 3 other meds for high-blood pressure).

This "doctor" is basing his diagnosis on dad's current mental condition. He's very emotional, crying at one point and then happy the next. I'm sure that this is largely due to his dementia (and I also wonder what all those neurological meds are doing to him). This "doctor" also uses dad's inability to sleep at night as an indication of "mania" (though he can sleep through the day). Hello? Even as a layperson I know that it's very common for someone suffering from Parkinson's disease to have problems sleeping at night.

All three of my dad's kids adamantly disagree with this doctor's diagnosis of "bi-polar", as well as my step-mom who's been married to him for over 10 years. This "doctor" told my step-mom that dad was able to hide his symptoms due to his intelligence and also due to the fact that my step-mom was a "stabilizing" influence. (Give me a break...if it was that easy to "hide" symptoms of bi-polar disorder, what the heck do we need any meds?).

My dad held the same job for over 50 years, my dad has never been depressed other than the normal type lows that everyone goes through in their lifetime. I've also never seen any sort of "mania" in all the years growing up with my dad. This doctor only met my dad when he was in the hospital suffering from dementia. How can he make this sort of diagnosis??? He's also a psychiatrist, not a psychologist. So he's never done any sort of psychological testing.

I don't know what to do to fight against this. My biggest concern are all the meds this idiot has my dad on. I don't know how these meds can effect Parkinson's???

My step-mom has power of attorney. Unfortunately she's of that generation that believes doctors are gods and are thus never wrong. I'm trying to fight for a second opinion. I'd like my dad to be seen by a geriatric specialist. Someone who must see a lot of dementia, a lot of Parkinsons, etc.

Does anyone know if the types of drugs I mention above can be harmful to someone with Parkinson's (especially this far advanced). And also, am I right the people with Parkinson's often times have problems sleeping at night?

Thanks so much...



I share your opinion of most doctors. I have pd and i have been through five neurologists.

I have taken trazadone to help me sleep. yes, most pwps have a problem sleeping. Based on the drugs you listed, none are parkinson drugs.

most people your dad's age are more sensitive to side effects. so in your dad's case less is better. their is someone, who is a friend, has taken care of her husband for 29 years. her screen name is googy, and her husband has dementia. she worked with her neurologist and they deleted all pd drugs except sinemet, the most effective pd drug. all of these drugs have side effects, so it is best to change or adjust his meds, depending on the side effects.

bipolar disease should be diagnosed by a specialist such as a neurologist or physciatrist. it is a catch all for people who are up and down with their symptoms.

Since your family has so many problems communicating with this doctor, drop him and see a neurologist.

i was a patient in a large hospital and all of a sudden the head shrink came in and began testing me while i was trying to eat lunch. later, i saw his diagnosis. he said i was just fearful of having surgery. i didn't know at the time i was going to have surgery.

hope this helps.

bruce
Quote from AliAyson:
I'm writing this for my dad who has diagnosed with Parkinson's at 81 years old (9 months ago). His Parkinson's progressed extremely rapidly. He doesn't have tremors, but he can barely walk (stiff, weak muscles) and he's starting to suffer from dementia.

First of all, I want to say that I'm sorry for your father's condition. It must be very hard on you and your family.
[quote]My dad went into the hospital about 30 days ago, he developed pneumonia from aspirating on his food (he has trouble swallowing). It was touch and go there for awhile, but he was able to pull through. One of the "doctor's" there (I use that term loosely) has decided that my dad has undiagnosed bi-polar disease. He's put my dad on THREE neurological meds: Depakote which is an anti-convulstant, Abilify which is a mood-stabilizer, and Trazadone which is anti-depressant (this is along with 3 other meds for high-blood pressure).
I know that this seems weird to you, but one of the biggest problems with Parkinson's disease is the emotional side-effects that surface due to the depletion of the dopamine (and other things) in the substantia nigra of the brain. The emotional side-effects are strongly influenced by the structural problem in the brain....depression and bipolar are common in PD patients. Depakote is an anti-convulsant, yes, but anti-convulsants, aside from lithium, are the mainstay of treatment for bipolar.
[quote]This "doctor" is basing his diagnosis on dad's current mental condition. He's very emotional, crying at one point and then happy the next. I'm sure that this is largely due to his dementia (and I also wonder what all those neurological meds are doing to him). This "doctor" also uses dad's inability to sleep at night as an indication of "mania" (though he can sleep through the day). Hello? Even as a layperson I know that it's very common for someone suffering from Parkinson's disease to have problems sleeping at night.
Yes, I agree with you that these symptoms are due to dementia, but dementia can cause mood instability and lead to a bipolar type illness which involves periods of mania. It's not that your dad is having trouble sleeping at night, it's the fact that he actually has less need for sleep....i.e. he's not tired when he's manic, so of course he's going to have trouble sleeping. Anyway, the point is, less need for sleep along with the other symptoms I'm sure the doctor screened for, is very specific for the manic episodes that can happen in dementia.
[quote]All three of my dad's kids adamantly disagree with this doctor's diagnosis of "bi-polar", as well as my step-mom who's been married to him for over 10 years. This "doctor" told my step-mom that dad was able to hide his symptoms due to his intelligence and also due to the fact that my step-mom was a "stabilizing" influence. (Give me a break...if it was that easy to "hide" symptoms of bi-polar disorder, what the heck do we need any meds?).
Your doctor, once again speaks the truth. There is something called the mini-mental status examination which can be used to summarize the mental status of an individual. A score of 24/30 or below denotes probable dementia; however, people that are more intelligent might get 29/30 and still be demented. Why? Because they are able to compensate. The thing is, it matters how your father's performance is now compared to before.....THAT is where the difference will lie. Also, studies have shown that people who have stabilizing factors in their lives like a spouse, progress in to dementia at a much slower pace. I assure you that your doctor is not trying to pull a fast one.
[quote]My dad held the same job for over 50 years, my dad has never been depressed other than the normal type lows that everyone goes through in their lifetime. I've also never seen any sort of "mania" in all the years growing up with my dad. This doctor only met my dad when he was in the hospital suffering from dementia. How can he make this sort of diagnosis??? He's also a psychiatrist, not a psychologist. So he's never done any sort of psychological testing.
That's just the point...your father sounds like he was a very high-functioning person. His manic/depressive episodes are a part of his dementia. Like I said before, depression and mania are very very common in dementia. Also, regarding what you said about psychologists/psychiatrists...psychiatrists are MDs....they went through 4 years of med school and 5 years of post-graduate training. THEY are the only ones that can legally make diagnoses (in adult psych at least)...psychologists are able to assess patients, and do certain aspects of psychotherapy, but they are not the ones who can prescribe drugs or diagnose things like bipolar (though they can suggest diagnoses)...
And yes....bipolar disease can show up acutely, and even if the psychiatrist didn't know your father before, as long as he is exhibiting the signs/symptoms of mania and depression now, the psychiatrist can make a diagnosis. I know you're confused, and I think that's a function of the doctor not explaining stuff to you like (s)he should.
[quote]I don't know what to do to fight against this. My biggest concern are all the meds this idiot has my dad on. I don't know how these meds can effect Parkinson's???
Well, the big thing with parkinson's disease is that you don't want to have them on drugs that have too many of what they call "extrapyramidal" side effects....these side-effects can mimic parkinson's disease in normal patients, so you can imagine that they would worsen things in a patient that actually has the disease. Looking at the drugs the doctor put your father on, they are not drugs that are known to have extrapyramidal effects.
[quote]My step-mom has power of attorney. Unfortunately she's of that generation that believes doctors are gods and are thus never wrong. I'm trying to fight for a second opinion. I'd like my dad to be seen by a geriatric specialist. Someone who must see a lot of dementia, a lot of Parkinsons, etc.
I'm totally with you here....get him to a geriatrician. But I'm pretty sure he or she will say the same thing. I know that this is a confusing time for you, but you have to remember the doctor is trying to help you.
[quote]Does anyone know if the types of drugs I mention above can be harmful to someone with Parkinson's (especially this far advanced). And also, am I right the people with Parkinson's often times have problems sleeping at night?
Like I said, the drugs above aren't known for their extrapyramidal side effects (EPS)...drugs that DO have EPS are the neuroleptic drugs such as chlorpromazine, flupenthixol, etc. etc. The newer, atypical neuroleptics like: risperidone, quetiapine, olanzapine, clozapine are better in that they have less EPS, but they can still affect patients that are sensitive; however, your dad is rightly not on a neuroleptic, so the doctor is doing something right there!

As for trouble sleeping at night, that is not a symptom that is part of the PD syndrome. I'm not saying that PD patients can't have trouble sleeping...I'm just saying that it's not a characteristic of the disease like stiffness, or tremors are. Less need for sleep, elation, irritability, impulsivity, lack of insight etc. etc. are signs of mania, and I am very sure that your dad's psychiatrist screened for those. Bipolar disease and depression are the bread and butter of psychiatry...they see those things EVERY DAY of their practice.

I think for your own peace of mind, it would be a good idea to get a 2nd opinion from a geriatrician...but please don't be angry if he or she says the same thing that the psychiatrist did.