When treatments for Parkinson’s disease are changed most people notice an improvement in their symptoms. Occasionally a change in medication can cause a worsening of symptoms. If the dose has recently been increased or a n
Common side effects include:
- Nausea and vomiting
- Feeling dizzy or lightheaded (sometimes due to low blood pressure)
- Feeling tired and sleeping excessively during the day
- Involuntary writhing movement termed as ‘dyskinesia’
- Confusion
- Hallucinations (seeing or hearing things that are not there)
Avoid abruptly stopping medication without first discussing it with a healthcare professional. Drug information can be found on the leaflet supplied with your medications
Urine infection can cause a worsening of PD symptoms.
Symptoms of a urinary tract infection (UTI) can include:
- Confusion
- Passing urine more often (sometimes)
- Discoloured or cloudy urine (some drugs used to treat PD may discolour urine)
- Unusually unpleasant smelling urine
- Pain on passing urine ( Not always recorded by PWP)
- Passing blood in your urine
- Abdominal Discomfort
- Generally feeling unwell
- Raised temperature or feeling feverish (Not always experienced by a PWP)If a urine infection is suspected, seek advice at your GP surgery. urgently. Take a sample of urine with you for testing. (DO NOT DELAY STARTING ANTIBIOTIC TREATMENT AS ANY DELAY WILL CAUSE THE UTI TO WORSEN WITH THE RISK OF HOSPITAL ADMISSION.)
- Chest Infections may also worsen your Parkinson’s. Symptoms include:
Persistent chesty cough
Feeling breathless or wheezy
Coughing up yellow or green phlegm
Raised temperature
Chest pain
Generally feeling unwell
If a chest infection is suspected seek advice at your GP surgery. Not all infections require antibiotics.
If you are having problems with swallowing and find you are coughing when eating and drinking, or have suffered multiple chest infections, it may be linked to your Parkinson’s. Most people with Parkinsons are offered an assessment with the speech and language therapy team at diagnosis or soon after to assess your swallow as well as the cough reflex and the tome of your voice. Often in put of the SALT can prevent chest infections occurring. Aspiration can be a symptom of your Parkinsons and is easily diagnosed by the SALT team.
Other infections may also cause problems with your PD. You will need to rest and drink plenty of fluids. Regular taking of paracetamol should help to treat fever and any aches and pains you may have.
Constipation
This is common in the general population particularly as we age. Mild constipation is not uncommon in PD and it could result in a worsening of your symptoms. Constipation can usually be managed by a healthy diet with plenty of dietary fibre, fluids and exercise. Sometimes laxatives such as Movicol may be required. See the Parkinson’s UK factsheet “Looking After Your Bladder and Bowels” for further information.
Chronic constipation can increase the risk of faecal impaction (where dried, hard stools collect in your rectum). Once you have faecal impaction, it is very unlikely that you will be able to pass the stools naturally, and this can cause the leaking of liquid stools which is sometimes mistaken for diarrhea. Any treatments to help diarrhoea will only make the problem worse.
A healthy diet, regular exercise, fluids, and fibre will contribute to healthy bowel management. Take note of your regular bowel habits. Take any laxatives regularly rather than as required as this will allow your bowel to get into a routine. You may find you need to take your laxatives twice a day, or it may be every 3 days, you will work out what suits you best. If you deviate from your normal pattern, you will need to visit your GP or practice nurse for further treatment or advice. Leaving constipation untreated can cause worsening of PD symptoms, UTI’s, confusion, or even hospital admission.
Dehydration is common in the general population. Sometimes if severe this can make your Parkinson’s worse. You should aim to drink 1.5 litres of fluid a day, possibly more in hot weather or if you are ill with diarrhoea etc. Symptoms of mild dehydration include:
Thirst
Dizziness or light-headedness
Headache
Tiredness
Dry mouth, lips and eyes
Concentrated urine (dark yellow)
Passing only small amounts of urine infrequently (less than three or four times a day)
To avoid severe dehydration increase your fluid intake and address any potential causes such as diarrhoea or infections. Symptoms of severe dehydration include:
An inability to urinate, or not passing urine for eight hours
Irritability
Sunken eyes
Low blood pressure (hypotension)
Weak pulse
Rapid heartbeat
Cool hands and feet
Fits (seizures)
Low level of consciousness
Feeling tired (lethargic) or confused
Blood in your stools (faeces) or vomit
Severe dehydration is a serious condition; you will need to seek medical help quickly as you may require admission to hospital.
- parkinsons and emergency admission
Other changes in your health will contribute to worsening of your PD symptoms. A common cold or un-controlled pain has the potential to affect your Parkinson’s. Once the underlying cause for the deterioration of your Parkinson’s has been successfully treated your Parkinson’s should return to how it was within a few weeks. If your Parkinson’s is still causing a concern please contact your Movement disorder team or your GP for further advice.