Getting the Most Out of Medications

[Farooqji]

“My husband has Parkinson’s, and we just got a new doctor a couple of months ago. Bob has been taking Sinemet ever since he was diagnosed. He always takes his meds first thing in the morning, then eats his breakfast. He has not been doing very well for some time…. Anyway, the doctor told him NOT to take the Sinemet with a protein…. We can’t believe how much difference this has made. Bob can walk a lot better and can even stand up straighter. We are amazed at how much better he feels and how quick he could tell the difference. I don’t know why he was never told about the protein and Sinemet before.”

—GAYLE W., PARKINSON’S CAREGIVER

For an average person with Parkinson’s, medications alone can cost several thousand dollars per year. And those who need therapeutic surgery may see bills in the six figures. This financial burden makes it doubly important that you are getting the most out of your medications.

Here are a few things you might like to try to increase the effectiveness of your medications.

• Take the medication as prescribed by your doctor. Make sure you understand the expected benefit and potential early side effects of a drug before you leave the doctor’s office. Remember that your doctor probably has more clinical experience in treating people with PD than anyone else who is likely to give you advice.

• Do not increase or suddenly stop any of your drugs without checking with your doctor first.

• Levodopa generally works best on an empty stomach, so aim to take your meds around a half hour before your meals, or at least an hour after. If your medication is causing you to feel nauseous, you may have to take it with food until your body adjusts. • Make sure you take your meds with four to five ounces of water so that the drugs are absorbed into your body quickly.

A tip my mom shared was to avoid eating large amounts of protein at any time. She found that eating too much protein really reduced the effectiveness of her meds (specifically levodopa).

Another tip Mom had for helping medications work better is to avoid sitting in one place for long periods of time. If you have to sit anywhere for more than an hour, try to get up every hour and do some stretching or moving around to keep your muscles from stiffening up too much. Mom said that regardless of when she last took her medications, sitting in one spot for a long time really made it hard to get moving again.

Though you may not always be able to achieve it, you should be aiming for as little off time (the time when you are basically having to stay put because your medications have worn off) as possible.

Most people with Parkinson’s find that after they take their meds there is a wait time before they kick in. Wait times are commonly 20 to 30 minutes, but because everyone is different this can vary, and it can depend on everything from how long a person has had the disease to what they last ate. In Mom’s case, she had to wait for up to 45 minutes (often less than this) after she took her medications for them to start working and for her to have on time (or in her words, for her to “have wheels”).

Her way of telling whether she was getting the most out of herwas to see how much time each day she spent in off mode. If she had to wait more than an hour for her meds to kick in or had more than four hours in one day in off time, she knew she needed to talk to her doctor about possibly changing the dosage and/or timing of her medications. (Note: It can be helpful for your doctor to know exactly when you’re experiencing your on and off times, as well as dyskinesia if you experience that, so that he or she may better prescribe your daily meds regimen. I’ve included a “PD ON/OFF Diary” in the free resources section of AllAboutParkinsons.com that will help you keep track of when you are at your best each day.)

One thing that helped maximize the effectiveness of my mom’s meds was that she was able to take them on an empty stomach. This wasn’t possible for her in the beginning because she got nauseous all the time when she took her meds (a common side effect of the drugs). But after her body got used to her medications, she was able to switch the timing. A tip she shared to reduce nausea is to take meds with crackers, juice, or ginger ale

Mom said the good thing about having less food in your stomach is that the meds work better, but sometimes it seems that they are working too well because you get more of the medication side effect dyskinesia. You might have to experiment a bit with the timing of your meals and meds to find out what works best for you

“Parkinson’s disease medications are as necessary for a Parkinson’s patient as insulin is to diabetics.

— Peter Schmidt, VP, Research Programs, National Parkinson’s Foundation”..

[wifeofparky]

Unfortunately, we learned the hard way also. Neither the Pharmacists nor the original neurologist told us this.