Anxiety with PD and the treatments?

Hi folks. I had to leave work about 3 weeks ago. I'm a teacher and felt like crying in front of not one but two classes. With the second one I realised it was time to go for a while. Clinicians are considering the best way forward to get me back to work. My immediate thought was 'I need dopamine replacement as I'm obviously low in this and ought to start Levadopa (I'm only on agonists at the mo'). However, after some internet research and liaising with my PD nurse, the verdict appears to be more that this will need to be tackled with anti-depressants and/or drugs like diazepam. I'm surprised but wondered what your views were? I used Propranolol for isolated challenging social situations for several years but the efficacy of this appears to be wearing off. Is it wise to take any drug for social anxiety that lasts ALL day?! Thanks

54 Replies

  • Dopamine will not help the emotional side of Parkinson's. I was on escatilapram ( anti depressant ) when I was at my Mother in Laws funeral and I did more crying than her kids. I needed an anti anxiety.

  • I am sorry, I do believe in this 23-day cycle, I have some bad days where I do cry and other days I couldn't cry even if I wanted to. I think you were having a bad day. Recently I was on Marty Hines do-it-yourself protocol. The do-it-yourself was just me. I could not afford to go and see a Marty Hines specialist. I knew I was under medicated but since I was having stomach problems I could not increase my dosage. L-tyrosine made my blood pressure Skyrocket. Since then I have seen a neurologist of all things a movement specialist and he put me on CR sinemet 50 / 100 three times a day. I am doing way better. I wood try sinemet for a while without the anti depression medication. Hope that helps , if it does not make any difference you can always go on anti depression medication Mary

  • Agreed that Sinemet CR is worth a try. It made all the difference for you and me both. No reason to delay taking it now that the "Sinemet causes early dyskinesia" myth has been debunked.

  • Have your thyroid checked - thyroid hormone imbalance can create crying spells. Make sure that your thyroid hormone levels are in optimal values:

    TSH within 2.5 mIU/L, even though the normal range can be up to 5 according to some labs.

    Free T4 1-1.53 ng/dl

    Would be also good to check for T3 but from my experience it is hard to convince doctors to do it, they tell me that level of T4 indirectly reflect on level of T3.

  • Hi Jeeves,

    I'm increasingly forming the view that there's no harm in at least trying a small dose of sinemet ..if it doesn't work I've lost nothing.

    And stepping up on all the good natural stuff, diet, exercise, supplements.

    Well worth Googling 'Alex Tressor' for a bit of inspiration.

    I have a prescription for Sinemet, if I use it, I'll let you know what transpires!

  • Minimum therapeutic dose is 3 sinemet per day

  • I'm very impressed that you're not just still working but you are working as a teacher. That's a tough job under the best circumstances. I take Lexapro for anxiety and depression, which are very much a part of PD for a majority of people. I am also on sinemet and don't know what I would do without it. I'm always a little mystified by the fear that seems to be around taking Carbidopa levodopa. I am nothing but grateful to have it. It made such a difference in my life. I was diagnosed four and a half years ago. Symptoms for about seven years. I find with PD, if I know I have to do anything the next day it causes a certain level of anxiety, depending on what the activity is. That's why I'm so impressed that you are still teaching. I also take Xanax if I absolutely need to. But mostly I try to organize my life so I don't need to.

  • I couldn't have put it better. You and I are symptom buddies.

  • It could be a lot worse. I just turned 66 and I have seen two good friends pass away with pancreatic cancer. Nobody's getting out alive. May as well try to enjoy the ride.

  • Thanks Enidah

  • why are caregivers so quick to throw drugs at everything? I urge you to try a couple of sessions with a hypnotist. I had crushing anxiety for YEARS. One session with a hypnotist and it was gone for good. Please. Drugs are bad long term. Especially anti depressants. If your local hypnotist doesnt help, then try drugs. Please please please

  • Interesting. Cheers

  • Hi bassofspades,

    I am a 69 year old female, dxd 13 years at age 56. I have been working with a hypnotherapist for 8 years now & I would urge caution when choosing one. I found a number of charlatans out there - far outweighing the genuine article. I am astonished that you were 'cured' after one or two sessions. I have overcome major adverse symptoms/side-effects using hypnotherapy including binge eating (Requip) & freezing. I have a healthy respect for drugs in the right place. People tend to recommend things of which they are aware - everyone knows of meds but not many people are aware of alternative treatments so can't recommend them.

  • I guess i got lucky. There are documented cases of hypnosis being beneficial for pd cases, although its not accepted by the ama so it would be inappropriate for an md to prescribe i guess. Just make sure hypnotist is certified and has good references.

  • Hi. I take theanine for anexity. It’s avitiam it’s a relaxation doc sayed ok.

  • How much do you take?

  • I also take l-theanine. I generally have worse anxiety in the morning, so I take it on first awakening, sometimes with a tiny dose of lorazepam, go back to sleep and wake up better. I take 400 mg. I tried the generic powder form (bulk) and it did nothing for me, my doc recommended Xymogen brand which helped a lot. You have to get a provider code for that, it's pricey but has been worth it for me. I also do 30 minutes of deep, slow breathing every morning. Big help. And I have the lorazepam for when I need it. I wouldn't be afraid of using anti-anxiety meds if you are careful not to use them every day. You might want to get evaluated to see if you're issues are more with anxiety, depression or it's both. Treatment will be different. And yes, EXERCISE. After vigorous exercise I always feel better.

  • Hi. One morning. One night.

  • Do you ever get all mixed up? One minute you feel good one minute you don’t? I feel anixty in my legs. Silly?


  • Dot, that is not silly. It's very common to feel anxiety in the legs. If I am anxious enough I definitely noticed that also. For me it's kind of a message that I need to change something or take better care of myself. Stress is perhaps the number one enemy for those of us with PD.

  • Hi. It be gone than it’s back again makes me feel awful. Gets to point I get mad

    Do u feel mad or sick when you get it too?

    Bang here it comes again

    People try to tell my future with pd. I just go day by day do you. Do you think ahead? People here are so nice too me.


  • I think it's absolutely imperative for people to feel they have some control over their lives. That's where exercise can come into play. We have to be our own bosses and get ourselves out there doing what we need to do to feel better. It doesn't help to sit around and think about what's coming because we don't actually know what's coming. I always feel better when I exercise, whatever it may be, when I clean the house, when I do some gardening, or visit with friends. Anything! We just need to be doing.

  • before you put pharmaceuticals in your body, give homeopathy a try. ignatia or gelsemium in a 30c or 30x potency. 4 little tablets under your tongue 2x day for 5-7 days. if you feel better before that, you can stop. no side effects, and very inexpensive. about $8 and youll probably have some leftover. ive seen both of these work wonders - in just a day, and sometimes within an hour.

  • Sounds worrying. I think a little madapor or sinamet would help.

  • Try a Google search for "anxiety Nortriptyline", without the quote marks.

  • Of course you need dopamine-ldopa/carba dopa. It will make you feel like yourself again. Get a good neurologist!!!!

  • yes i agree. if its the dopamine that you need, you will know right away - after your first or second dose, you should start feeling better. if not, then try the homeopathy (that i mentioned in my earlier reply) before taking drugs with all their side effects.

  • Jeeves i totally empathise with you. I was crippled with anxiety and lived as a constant ball of stress. When i was dx in June 15 i was immediately put on Zoloft. It took about 2 mths but changed my life. No more anxiety.

    I was reluctant to start pd meds (Madopar) but did so in Oct 16. Another less dramatic but still positive change.

    I do not regret either decision.

    I wish you well. To live with anxiety and stress in PD is horrible.

  • Hi DEAT. It's not a generalised anxiety, it's more when I have to face numerous people and deliver something that I sort of have a freak out and my ability to confront people has lessened enormously over the years (which isn't great considering I'm a manager of people!). But thanks -and thanks to all - for taking the time to chip in.

  • Oh, by the way, jeeves 19, I am on levodopa for PD, and I am a public speaker and perform music in front of many people, at times. I, also, have taught music. I hope you and your medical team can come up with a solution, so that you can get back to work. Best to you!

  • I understand what you mean. In my case the Zoloft resolved those social situations also.

    I left my job because of undiagnosed PD and feel sad now in hindsight. I feel if i had been medicated for anxiety i could have remained in work longer. I had lost my confidence.

  • Well put! Exactly my problem. I gave presentations, but no more. I’m not saying stop trying. Just remember there is progression to this disease regardless of all the medication. I wish you the best.

  • My pharmacist warned that Lexapro and Azilect should not be taken together to avoid a serotonin storm. My Neuro tells me continue both Azilect 1mg morning and Lexapro 5 mg evening. Lexapro makes me a Zombie sleepy all the time and Neuro calls that it's sedative effect. I too have to work and stopped taking Lexapro. Thanks for the alternatives to anti-depressants mentioned here. Ashwagandha seems to help my symptoms

  • jeeves19 I certainly can empathize. I had gone through a particularly difficult time, when somebody lashed out at me , in a cruel and demeaning manner, for, literally, no reason at all. For some reason, it really bothered me. I don’t know if it’s because of PD or not. For many years I’ve handled management positions, where I’ve had to deal with many volatile verbal flare ups from employees etc, and I managed them all fairly well. The person that did this verbal barrage at me recently, is not a friend, or anybody that I like, just a neighbor, who was acting weird, I guess. Anyway, the doctor put me on anti-anxiety medicine, only to be taken if absolutely needed. So, for me, it’s good to know that I have something to help me, if I have another reaction like that. Each person is different, but I would certainly consult with your doctor and see what they could do to help you.

  • Thank you

  • I train grioups at work and being put on citalopram ssri worked well. I am like you I also take beta blocker propanalol. I understand citalopram is suitable for PWP. Best

  • Jeeves, I had the same anxiety you have. Couldn't attend meetings at work because of my anxiety. It was very debilitating. What helped me is taking Azilect daily. After about two weeks of taking Azilect my anxiety went away.

  • It's weird what triggers us. I'm fine with groups of people and public speaking. Driving is what makes me anxious, on motorways. Not always, some days I'm fine. But other days, I just feel incredibly anxious and convinced the person in the car behind me is critiquing my driving!. Theanine helps a lot.

  • Love the new pic!

  • Just to say that I was diagnosed 5 years ago. Symptoms a few years longer. I put off Sinemet because I was worried about the long term side effects. I was miserable between anxiety and ridgidity. Finally after many with PD said try the sinemet. several hours into the first day I cried. I hadn’t felt that good in years. Previously doctor wanted to prescribe an antidepressant. I resisted. Don’t need it now. Sinemet helps so much with a lot of PD ailments.

  • My story. My anxiety far out ways movement which totally bites. Because they are trying to fix me, every time I went to see my PD doctor my blood pressure went through the roof. My blood pressure ( I kid you not was like 168/138 ) . Once it was so high I did 50 pushups to burn off extra energy and it did nothing to drop my blood pressure. So take what you need to get through your day.

  • Jeeves you could be like me and if so teaching maybe very hard to do soon. It is my personal experience that there is no way of turning back the clock. I have had to concede my head of house hold title to my wife. Time... day... words.... names.... due dates... have become abstract to me.

  • Just wondering if everyone at your workplace (school) knew about your PD, or did you kept it secret?

    Initially I tried to conceal my condition which became quite stressful. Being open about it is easier, and one thing less to worry about.

  • I've always been open about it actually. Not that it got me any sympathy mind. You'd tell somebody then in the next breath they'd remind me that a particular deadline needed meeting!

  • Hi Jeeves

    I am also a teacher who was Dx in September this year. I have taken some extended leave at this stage. Teaching PE, sport and senior theory classes has become difficult with voice issues, dystonia and the fear of a collision leading to a fall.

    Anxiety is reduced when you don’t have to face classes and meet deadlines.

    I am using the time to become more educated on PD, attend PD Warrior and support group and planning some travel. At this stage, I am also weighing up my options. I have greatly enjoyed teaching and have built significant relationships with students and colleagues. It may soon be over but I am leaving while I am still having a positive impact.

    It was an emotional time sharing my Dx with my students. They were supportive and the clued in ones had already worked out I was not 💯 %.

    All the best going forwards


  • Thanks Bron. Love the idea of travel but sadly I have a mortgage still to pay and 2 kids to raise! Wish I could win the lottery.

  • My husband took nudexta and it worked, but was pricey so they put him on zoloft I believe. It took care of the crying.

  • I feel for you!, I used to be able to control the tears, but no more. They can happen spontaneously now and it’s embarrassing to say the least. My personal feeling is you probably can’t find the right medicine to combat that without upsetting something else. I finally stopped the medication hunt and now live with and accept certain things will never be the same again. That in itself has decreased my anxiety 50%. The stress of your job may now have to be reckoned with. We all come to that day eventually. I wish you the best and hope you find relief.

  • Thanks 😀

  • Obviously, medications play a necessary and important role in PD. I am also aware that clinical depression can be a chemical imbalance and it's not enough to merely say "pull yourself by your bootstraps and get over it." Meds can be needed.

    Still we cant forget there is an important "supplement' to drugs. It is our own focus. We go the direction we are looking. If all we see is the crisis of Parkinson's we will remain in crisis. However, if know we are much more than a person with Parkinson, we look to those things. If we focus on the fact we can help others no matter the limitation of that help, are focus on living for others. Then Parkinson is part of our lives, but not our whole lives.

    Next time things seem to be overwhelming get all the help you can, then look to help others.


  • Cheers Bart😊

  • After years of depression, we used L-theanine very successfully. Look it up here. Started w 100mg every 4 hrs and worked up to 400mg.

    I would stay away from affects motor control and put my husband into a wheelchair go years. When his new neuro took him off, after two days he got up and didn’t use one again for years and then only due to heart issues.

  • Thanks Donzim. Hope you're both well.

  • Well I will add my 2 cents for what they are worth. Anti - anxiety meds are a wonderful thing they give them out to most all people today young and old. Don't be afraid of them but embrace them. I have been on the same dose for the last ten years.

    Sorry but just go on the carbi deopa/leva dopa, or sinetmet whatever it is . You will feel so much better that you will be sorry you have not done it before. You will eventually get fed up and get there either way in the ncext few months so save yourself some time.

    I worked for two or three years after being diagnoed in a very stressfull IT job. You will just know when the last day has come. Hang in there. IT may have come already.

    Acceptance comes much later.

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