Fluctuating blood pressure - role of P.D. drugs which impact catecholamine production and levels

[pen1]

Is there anyone out there who knows about ,or is researching, the relationship between P.D medication and paroxysmal hypertensive crises - aka pseudopheochromocytoma ( link to desciption below) with particular reference to altered levels of catecholamines

Dysautonomia is a feature of advanced PD, Though its severity and impact varies hugely between individuals, it undoubtedly contributes to wildly fluctuating b.p and hypertensive crises which are just beginning to be recognised as a feature in some people with advanced PD.

I am trying to find out if there has been any research into role of the PD drugs which have a direct effect on catecholamines - COMT inhibitors, eg entacapone..opicapone , MAOI (B)s eg safinamide rasagaline, and SNRIs eg mirtazapine.

Over a year ago I eliminated completely the increasingly severe episodes of pseUdopheochromocytoma which I had begun to experience, and which my Dr was unable to diagnose more specifically than ' part of the dying process'. I did this by reducing my daily intake of mirtazapine (an SNRI) from 30mg to 7.5 mg.

It seems obvious that drugs affecting catecholamines will be contributing at the very least to blood pressure problems but I can't find any research on line..

Any more information / ideas welcome

Many thanks

Jan

Info on symptoms etc of pseudopheochromocytoma are at: ncbi.nlm.nih.gov/m/pubmed/1...

[johntPM]

Perhaps the only advantage of the short half-life of levodopa, about 90 minutes when taken with carbidopa (e.g. Sinemet), is that it makes testing yourself easier. As a first step you could measure your BP immediately before a dose and a hour after the dose. Repeat , perhaps 10 times, to get a feel of the statistical significance.

There has been talk of using the slower variations of BP in response to, for instance, movement as a way to measure PD.

It would be interesting to know which of the symptoms as caused by the PD and which are caused by levodopa, etc..

[park_bear]

Based on your report it would seem that the mirtazapine was responsible. Is there any reason to think otherwise? I did a search on Google scholar and it was not informative. Adverse reactions are very much underreported. To report this adverse reaction see this link: fda.gov/safety/reporting-se...

[aspergerian]

Cardiac sympathetic denervation preceding motor signs in Parkinson disease.

David S. Goldstein, MD, PhD, Yehonatan Sharabi, MD, [...], and Graeme Eisenhofer, PhD.

2007 .

ncbi.nlm.nih.gov/pmc/articl...

[pen1 in reply to aspergerian]

Fascinating. Thanks very much for this.

[aspergerian in reply to aspergerian]

Also:

Cognition and Visit-to-Visit Variability of Blood Pressure and Heart Rate in De Novo Patients with Parkinson's Disease.

2016.

ncbi.nlm.nih.gov/pubmed/276...