Have recently been diagnosed with Parkinsons and prescribed Co-careldopa 12.5mg/50mg tablets to be introduced gradually 1 a day week 1 - 2 a day week 2 3 a day week 3 etc. After several days I have noticed very unpleasant Jitteriness/restlessness and heightened anxiety after taking my medication. Is this normal? Perhaps there is an alternative drug which has a better side affect profile? I would be grateful for any feedback
thanks
Hi @GROBER
Thank you for sharing your experience, I am sure others will have some advise for you. Have you had a look at the information on our website regarding drug treatments - https://www.parkinsons.org.uk/information-and-support/managing-drug-treatments-parkinsons. Also if you are experiencing some problems I would advise you to contact your Parkinsons nurse to discuss the way forward. If you do not have a nurse available to you please do contact our helpline on 0808 800 0303 or email them at [email protected] and they will be able to put you through to one of our specialist nurses for some general help/advise.
Regards
Sue - moderation team
THANKS for the prompt reply Sue. I have multiple health problems following bowel cancer surgery which has left me with heightened anxiety. I was wondering if there are any Parkinson drugs which are better in this respect - or perhaps any adjunct drugs-anxiolitics to help combat this heightened restlessness which is very difficult to handle.
Hi @GROBER,
I thought I’d chime in here just to echo what Sue has suggested, please do give our helpline a call for more support on this and you may wish to check out some threads on the forum that have had conversations about their experiences with anxiety. I’ve listed a few below for you:
Best wishes,
Reah
When I read posts like this, I find myself wondering how long it will be before Parkinson’s UK put some information about Akathisia on their website. I note “very unpleasant Jitteriness/restlessness and heightened anxiety AFTER taking my medication” ie. It is a drug-induced side effect. It is extremely important for a patient to know that many drugs can cause akathisia and it is dangerous to withold that information from them. If one drug causes akathisia then you take another that also causes akathisia you are heading for double trouble. I have had akathisia since 2002. No health professional ever warned me about it. I had to find out about it on a patient forum when I recognised a patient describing the symptoms. By then the damage was done.
CO-CARELDOPA 25/100MG TABLETS UK PIL Oct.2017
Possible side effects: Depression, feeling anxious, feeling agitated
Co-careldopa Side-effects: anxiety; depression; suicidal ideation
Co-careldopa-Brand names: Sinemet, Caramet, Apodespan and Lecado
Side effects: mood changes, including anxiety or depression, thinking about hurting yourself
https://books.google.co.uk/books?id=g815isikVSAC&pg=PA1338&lpg=PA1338&dq=david+marsden+akathisia&source=bl&ots=L18aKKQNWL&sig=ACfU3U2745iuss8ufDwDZIaifrYlAj50jw&hl=en&sa=X&ved=2ahUKEwiP6cippN7gAhVAAmMBHatZDOEQ6AEwC3oECAIQAQ#v=onepage&q=david%20marsden%20akathisia&f=false
Marsden’s Book of Movement Disorders I.Donaldson, C. D.Marsden, S. Schneider, K.P.Bhatia OUP 2012
Chapter 46: Akathisia I.Donaldson, C. D.Marsden, S.A. Schneider, and K.P. Bhatia
Although akathisia was described in idiopathic and post-encephalitic Parkinson’s disease in the early literature (Bing 1923 and Sicard 1923) it has largely been ignored since then…The majority of patients with Parkinson’s disease periodically experience the need to move and are unable to remain still.
Parkinson’s disease is frequently associated with akathisia…In a small number of patients akathisia was an early symptom of Parkinson’s disease, but in the majority it developed later, most often after antiparkinsonian medication (Lang&Johnson 1987)
Similarly, Comella and Goetz (1994) found evidence of akathisia in 45% of a group of patients with Parkinson’s Disease and they described the symptoms as being clinically significant in 21%
Patients may be able to temporarily suppress this motor activity, but this results in a build up of inner tension and distress, eventually forcing them to move. The more severe the condition, the shorter the period of immobility they can tolerate…Most people with moderate or severe akathisia are markedly distressed by their symptoms (Braude et al 1983) and they can become so extreme that they lead to hospitalization, violence, or attempted suicide
SPECIAL REPORT PART II How GlaxoSmithKline Suppressed Data on Paxil-Induced Akathisia: Implications for Suicidality and Violence Peter R. Breggin, MD Ethical Human Psychology and Psychiatry, Vol.8, No.2, Summer 2006
The Expurgation of Akathisia.
It is extremely important for physicians to know that a drug can cause akathisia. Akathisia, as a term, signals the dangers of emotional anguish and the potential for inducing suicide and violence.
It is not only fraudulent but also hazardous to patients to hide that a drug can cause akathisia. It is especially dangerous when the drug is being used to treat depression, because akathisia in depressed patients is especially likely to drive them to suicidal or violent acts. Akathisia was systematically eliminated by SKB (now GSK) as a preferred term from the U.S. and non-U.S. studies.
This meant that symptoms typical of akathisia would not be coded as akathisia, but as something else, such as agitation or central nervous system stimulation. (Preferred terms are the words used to describe specific adverse effects, such as akathisia, agitation, or mania. They are selected from a codebook provided by the FDA. If akathisia is not listed by the company as a preferred term in its plan or protocol for a study, then investigators will code or list akathisia as something else, such as agitation. Almost any term is less threatening than akathisia.)
… We shall also find that cases of akathisia were hidden in company-defined preferred terms (i.e., terms preferred by the drug company such as agitation, anxiety, stimulation, nervousness, and tremor).…A total of 49 of 75 agitation patients were in fact suffering from akathisia…Under the category ‘‘nervousness’’ (pp. 235–238), 44 of 91 were probably related to akathisia. They were identified by the following terms: pacing, jumpy, jittery, and fidgety. Jittery was the most common.