Confused

I was diagnosed in 2015 and was really quite ill when I was. This was due to me ignoring the many symptoms I had which had started a good 18 months prior. I had totally lost my sense of smell, I had no co ordination, walking was slow and sluggish, I had very little strength, sweating, mild tremor, I struggled to get out of my car, my balance was awful, I was lethargic and constantly exhausted and my anxiety was through the roof.
After a very short period of time on Sinamet Plus, a lot of these symptoms were improving massively and I felt well again in myself,
Over the past 5 years I have had the Sinamet increased usually about every six months when I feel the need,
Now I find nothing seems to be working. After a few falls and a couple of warning signs of some of the above symptoms returning, I contacted my P.Nurse. In addition to Sinamet, I tried a patch thingy which set my skin off, Something else and Pamipraxole which gave me blinding headaches and sent me to sleep, Therefore she advised that until I could get to see the Specialist, I increase the Sinamet again.
One of my main problems is body jerking. This started about 3 - 4 months ago and before the meds increase. My problems are all down my right side and my right foot has constantlty throughout tremored which gets worse in the evenings this is really uncomfortable and annoying. Now my arms, legs and whole body is twisting and jerking and where I have always been able to hide my PD now I cant. Evening times trying to relax are awful I cant sit still and when I get to bed I cant settle and take ages to get to sleep. It can be painful and upsetting. Now I can feel I am starting to feel the way I did in 2015 and I don’t want to ever go back to feeling like that. I am 64 and on 200mg Sertralene for anxiety and depression.
I have sleep disorder which I have been told consists of me sitting up and screaming so between this and that and stiffness when I try to get up bed times can be a challenge. I have received a video appointment with a specialist on 27th August. Has anyone any miraculous ideas that may help,

Thank you for reading

Chris

Hi Chris. So sorry you’re struggling. I’m no professional, but your sleep rings a bell as my husband suffers from the same disturbances and apparently it’s called REM sleep disorder. Check it out on this site. I hope you find some solutions .

Hi @Chris, thanks for posting and sorry to hear about the increasing difficulties that you have been experiencing.

Our website has a section on Sleep and Parkinson’s, including difficulty getting to sleep and sleeping comfortably, and also information on Parasomnias (unusual movements and behaviours during sleep) on the sleep and mental health page.

I’m glad to hear you’ve got a video consultation coming up soon, you might find it useful to keep a symptoms diary in advance of your appointment, and make some notes of the questions you want to ask. If you’ve got an email address for your specialist it might help emailing them in advance of your appointment too.

Do also contact our Helpline and Local Adviser service, we have dedicated Nurse Advisers that can give you further advice on the symptoms you are experiencing.

Best wishes,
David
Forum Moderation Team

Hi, I posted last October outlining the role of Sertraline in the development of my movement disorder:

Antidepressants and movement disorders Antidepressants and movement disorders

“can’t relax…can’t sit still…distress…difficulty getting to sleep” all sound like akathisia to me.
Akathisia is often mischaracterized as anxiety & depression
“twisting and jerking” sounds like athetosis & myoclonus

Unfortunately problems caused by drugs may be met with denial denial & denial.
You have time before your appointment to figure out a timeline.
Start by listing any drugs you have taken in chronological order.
Then sandwich in the symptoms as they appeared.
Then get your google fingers out and start looking for those symptoms among the side effects listed for each drug.
You may also come across case reports which detail individual patient’s experiences as cautionary tales
Parkinson’s itself can be caused by many drugs so don’t forget to check if there were any suspect drugs before you started developing symptoms
You can probably produce a clear and simple 1 page summary to copy to your GP & neurologist. This will save you repeating yourself ad nauseum over the years.

https://www.medicines.org.uk/emc/product/7809/pil
Sinemet Plus Merck Sharp & Dohme Limited Last updated on emc: 22 May 2019
PACKAGE LEAFLET: INFORMATION FOR THE USER
Possible side effects:
mental changes including delusions, hallucinations and depression… feeling anxious
Some patients experience severe abnormal involuntary movements (dyskinesias),

https://www.medicines.org.uk/emc/product/7809/smpc
Sinement Plus This information is intended for use by health professionals Last updated on emc: 20 May 2019
4.8 Undesirable effects
Nervous System/Psychiatric: depression with or without development of suicidal tendencies… anxiety

https://www.medicines.org.uk/emc/product/1070/smpc
Lustral [Sertraline/Zoloft] Pfizer Limited . Date of revision of the text 02/2018
This information is intended for use by health professionals

Akathisia/psychomotor restlessness
The use of sertraline has been associated with the development of akathisia, characterised by a subjectively unpleasant or distressing restlessness and need to move often accompanied by an inability to sit or stand still. This is most likely to occur within the first few weeks of treatment. In patients who develop these symptoms, increasing the dose may be detrimental.
4.8 Undesirable effects
Common: anxiety, depression, agitation, nervousness
Uncommon: suicidal ideation/behaviour, psychotic disorder, thinking abnormal, apathy, hallucination, aggression,
Nervous system disorders
Common: tremor, movement disorders (including extrapyramidal symptoms such as hyperkinesia, hypertonia [rigidity], dystonia, teeth grinding or gait abnormalities), paraesthesia,

Resources:

https://missd.co/
MISSD (The Medication-Induced Suicide Prevention and Education Foundation in Memory of Stewart Dolin) is a unique 501c3 non-profit organization dedicated to honoring the memory of Stewart and other victims of akathisia by raising awareness and educating the public about the dangers of akathisia. MISSD aims to ensure that people suffering from akathisia’s symptoms are accurately diagnosed so that needless deaths are prevented.

https://rxisk.org/akathisia/
Akathisia is an emotional state caused by over 100 different drugs, primarily antidepressants and antipsychotics, but also antibiotics, anti-hypertensives and others. It causes suicidality, homicidality and other disturbances of behavior

https://projectteachny.org/wp-content/uploads/2017/09/Barnes_akathisia_scale.pdf
Barnes TR (1989) A rating scale for drug-induced akathisia. British Journal of Psychiatry 154: 672–676