Early this year doctor decided i have early stages of Parkinsons.We tried sinamed,mirapac,Azilet and new patch recently approved by FDA None of these medicines as well as PT helped my balance. Please suggest what I should do next.
Dr. Sanchez-Ramos said...
The first stage of idiopathic PD involves only one side of the body (perhaps decreased dexterity of the hand, rest tremor, slowness). Gait and balance problems are not part of the first stage of PD but tends to appear later in the course of the illness. If balance, gait and falls are the first manifestations, then you may not have idiopathic PD, but perhaps have another disorder that mimics some aspects of PD. The earliest stage of PD may not even require medication right away. Often the classical signs and symptoms of slowness of movement, rest tremor and rigidity do not interfere with everyday activities and so it may be worth waiting before starting dopamine replacement therapy. If you are under 60 and need symptomatic relief then dopamine agonists such as pramipexole (Mirapex) or ropinirole (Requip) may be useful. If you do not need symptomatic relief, then Azilect may delay the need need for levodopa/carbidopa (Sinemet), the most effective medication for relief of slowness and rigidity of PD.
If your main problem is gait and balance, and not slowness of movement, rigidity and tremor, then one wonders if you really have idiopathic PD.