Sleepy problem

[2011rav]

Been taking CL for sometime now and it appears that it is making me sleepy. Anyone else have this problem?

Wil

[TheGimba]

What's CL? My husband has had PD for six years. He presented with a major sleep disorder at 50. He takes a stimulant now Concerta which helps but too much made him aggressive. He took modafinil for a while which did help somewhat at first. He was sooo sleepy that it threatened his ability to work part time. He still struggles with this. He uses a cpap machine at night because he was diagnosed with sleep apnea. Not sure if any of this helps..just wanted to say that sleep issues can be severely life altering and it was very difficult to get doctors to take this seriously.

[2011rav in reply to TheGimba]

CL is Carbidopa levodopa Enta 75mg. Sorry I did not explain it.

[etterus]

Most definitely I take Ritari four times a day ;285 levodopa. I could sleep all day if I wanted to. But at least I'm sleeping at night.

[S70AWD]

I only started on C/L three weeks ago, but it is making me unbearably sleepy, to the point that I can't stay awake to drive or function at work.

[aspergerian]

In addition to 50/12.5 mg of L/C, amantadine, and Mucuna, I now take 5 mg of methylphenidate each morning, very helpful.

May 24, 2016

To: "My" neurologist

Fr:

Teresa C. Binstock

Treating

fatigue and fragmented sleep in Parkinson's disease: methylphenidate

Here is a small miscellany of relevant

citations relevant to my fatigue, sleep, and methylphenidate.

Highlights have been added.

A. Fatigue and/or daytime

sleepiness are common in PD (1-2); are often unrecognized clinically

(3-4).

B. Methylphenidate for PD patients has been studied and

has generated positive findings (5-8).

C. Methylphenidate and

amantadine augment one another (9).

1.

Fatigue and

excessive daytime sleepiness in idiopathic Parkinson's disease

differently correlate with motor symptoms, depression and

dopaminergic treatment.

Valko PO, Waldvogel D, Weller M,

Bassetti CL, Held U, Baumann CR.

Eur J Neurol. 2010

Dec;17(12):1428-36.

"Fatigue was found in 52 (59%),

EDS in 42 (48%), and both complaints in 31 (35%) patients.... In PD,

there is a significant overlap of fatigue and EDS, but the two

symptoms are differently correlated with the severity of motor

symptoms, disease duration, depression, and dopaminergic

treatment."

2. Sleep

dysfunction and its management in Parkinson's disease.

Kutscher

SJ, Farshidpanah S, Claassen DO.

Curr Treat Options Neurol. 2014

Aug;16(8):304. [open

access]

ncbi.nlm.nih.gov/pubmed/249...

3.

Fatigue in Parkinson’s disease: report

from a mutidisciplinary symposium

Joseph H

Friedman, et al.

npj Parkinson's Disease (2016) 2, 15025;

[open

access]

nature.com/articles/npjpark...

4.

Non-recognition

of depression and other non-motor symptoms in Parkinson's disease.

Shulman LM, Taback RL, Rabinstein AA, Weiner WJ.

Parkinsonism

Relat Disord. 2002

Jan;8(3):193-7.

ncbi.nlm.nih.gov/pubmed/120...

5.

Effects of

methylphenidate on cognitive function and gait in patients with

Parkinson's disease: a pilot study.

Auriel E, Hausdorff JM,

Herman T, Simon ES, Giladi N.

Clin Neuropharmacol. 2006

Jan-Feb;29(1):15-7.

ncbi.nlm.nih.gov/pubmed/165...

6.

Improvement of

gait by chronic, high doses of methylphenidate in patients with

advanced Parkinson's disease.

Devos D, Krystkowiak P,

Clement F, Dujardin K, et al

J Neurol Neurosurg Psychiatry. 2007

May;78(5):470-5. [open

access]

ncbi.nlm.nih.gov/pubmed/170...

7.

Methylphenidate Found to Help Parkinson’s

Disease Gait Problems

BY TOM VALEO

[open

access; synopsis of Moreau et al 2012

(8)]

journals.lww.com/neurotoday...

8.

Methylphenidate

for gait hypokinesia and freezing in patients with Parkinson's

disease undergoing subthalamic stimulation: a multicentre, parallel,

randomised, placebo-controlled trial.

Moreau C, Delval A,

Defebvre L, Dujardin K... Devos D; Parkgait-II study group.

Lancet

Neurol. 2012 Jul;11(7):589-96.

9.

webmd.com/interaction-checker/

Interaction Warning 1

interactions found for the 2 drugs listed below. View

Detail

Interactions for the following medications

amantadine

HCl Oral

methylphenidate

Oral

All

(1)

Do Not

Take Together (0)

Serious

(0)

Significant

(0)

Minor (1)

Minor:

Interaction is unlikely, minor, or nonsignificant

amantadine HCl oral + methylphenidate oral

amantadine HCl oral, methylphenidate oral. Either increases the

level of the other by added drug effects

Additional Information: Combination increases

stimulation of the nervous system.