Hi, new here and hoping for some advice for my mum. She was diagnosed several years ago. Her first symptoms were extreme fatigue. She’s now 87 and has had muscle pain for some time (back, neck, groin area) and the fatigue is completely debilitating. She’s on Madopar. It doesn’t seem to do anything to combat the fatigue. This is by far the most pressing symptom. I read about the exercises that people with PD are doing but my mum can barely walk about the house without having to rest so doing exercise of any sort seems out of the question without a monumental effort which then could knock her out the next day. She’s falling asleep in her chair all the time and has no energy. She doesn’t wake refreshed at all. Is there any medication that might help with this? Or is it a case of persisting with trying to do very small bouts of exercise (maybe chair yoga?) I appreciate her advanced age but I know if it wasn’t for the fatigue she would be able to do a lot more. She has been prescribed rasagiline which she started taking but thought it made her feel dizzy/weird. Anyone else had this and had side effects? It’s hard to know if that was the cause of the dizziness as she has had bouts of that previously. Any advice gratefully received, thank you.
Hello @Susan_Gibson welcome to the forum. We hope you find it a helpful place to connect, ask questions and hear from people who really understand.
We’re sorry to hear that your mum is struggling with fatigue and this is really impacting her. It must be hard for both of you. It’s great that you’re looking into what could help. It’s clear that you really care about your mum and want to help in any way that you can.
We’ve got information on fatigue, how to manage it and treatments on our website, which you and your mum might find useful: Fatigue | Parkinson's UK. This includes exercise, so chair yoga could be helpful for your mum. We hope the community will also share what they’ve found helpful.
If you’re worried about your mum’s medication and any side effects, please speak to her GP, specialist or Parkinson’s nurse. We are also at the end of the phone for you both. You can call us for free and speak to our trained advisors: 0808 800 0303.
Take care 
Parkinson’s UK Moderation Team
Good afternoon Susan. Sorry your Mum has Parkinson’s. The Parkinson’s nurses here are brilliant & well worth talking to.
I also use Artificial Intelligence {Ai}, Either Go Pilot or Google Gemini. It is free to use & can explain things that non medical peole do not understand. Ai is also brilliant for generating questions you can ask your Mums medical team.
I put your post into Ai & it came up with …..
It makes complete sense that you’re looking for anything that might ease your mum’s fatigue — when fatigue becomes the dominant symptom in Parkinson’s, it can overshadow everything else. I’ll walk through what’s known medically, what tends to help, what might be worth discussing with her clinician, and how to think about exercise when she’s already exhausted. I’ll keep this grounded, compassionate, and safe — and I’ll flag clearly where professional input is essential.
The short, direct takeaway
Severe fatigue in Parkinson’s is common, often under‑treated, and rarely improved by Madopar alone.
There are other medication classes that clinicians sometimes consider for Parkinson’s‑related fatigue, but they must be evaluated carefully — especially at age 87.
Very gentle, extremely low‑intensity movement can help some people, but only when paced correctly and never pushed through exhaustion.
Why fatigue becomes so overwhelming in Parkinson’s
Fatigue in PD is not just “tiredness.” It’s a neurological symptom driven by:
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Dopamine depletion (Madopar helps motor symptoms more than fatigue)
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Sleep fragmentation and REM sleep disruption
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Autonomic dysfunction (blood pressure drops → dizziness → exhaustion)
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Muscle rigidity and pain draining energy reserves
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Mood changes (apathy, depression can amplify fatigue)
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Medication timing or under‑treatment of motor symptoms
At her age, these factors often stack together.
About Madopar and rasagiline
Madopar (levodopa + benserazide) is excellent for motor symptoms but not reliably effective for fatigue.
Rasagiline (MAO‑B inhibitor) can help some people with energy and “wearing off,” but:
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Dizziness is a known side effect
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It can worsen orthostatic hypotension (blood pressure drops when standing)
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It may take several weeks to judge properly
If she already has dizziness episodes, it’s very plausible she felt “weird” on it — but it’s also possible the dizziness was unrelated. Only a clinician can safely judge whether retrying at a different time or dose is appropriate.
Medications clinicians sometimes consider for Parkinson’s fatigue
I cannot recommend specific treatments for your mum personally, but I can tell you what doctors sometimes explore in PD fatigue so you know what to ask about.
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Modafinil — occasionally used for excessive daytime sleepiness; mixed evidence for PD fatigue.
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Methylphenidate — sometimes used off‑label to improve alertness; must be used cautiously in older adults.
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Antidepressants — if fatigue is linked to apathy or low mood.
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Adjusting levodopa timing — sometimes fatigue worsens when motor symptoms are under‑treated.
These are not universal solutions, and at 87, risks and interactions matter enormously. But they are legitimate topics to raise with her neurologist or GP.
Pain, stiffness, and fatigue are tightly linked
Her back, neck, and groin pain can worsen fatigue dramatically. Clinicians often look at:
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Muscle rigidity → adjusting levodopa timing
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Arthritis or spinal issues → separate treatment
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Poor sleep due to pain → addressing nighttime discomfort
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Undertreated constipation → surprisingly common fatigue contributor in PD
A full pain review can sometimes unlock more energy than changing PD medication.
Exercise: what’s realistic when she’s already exhausted?
You’re absolutely right: the typical PD exercise programmes are far too demanding for someone who can barely walk around the house.
But movement doesn’t have to mean “exercise.” The goal is micro‑movement, not workouts.
Gentle options that don’t trigger next‑day crashes
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Chair‑based mobility — 1–3 minutes at a time
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Breathing‑based stretching — reduces rigidity without exertion
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Very slow sit‑to‑stand practice — once or twice a day
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Hand and foot mobility — improves circulation and alertness
The key is pacing: stopping before she feels tired, not after.
Even 60 seconds of gentle movement can help reduce stiffness and improve alertness without triggering exhaustion.
Red flags worth discussing with her doctor
Given her age and symptom pattern, it’s important to rule out treatable contributors:
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Low blood pressure (very common in PD and causes dizziness + fatigue)
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Anaemia or thyroid issues
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Sleep apnoea
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Medication interactions
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Depression or apathy
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UTIs (can cause sudden worsening in older adults)
A GP can check these with simple tests.
What you can do next
If you want, I can help you:
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Draft a concise summary for her GP or neurologist describing her fatigue pattern
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Explore non‑drug fatigue strategies that are realistic for her mobility
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Look at chair‑based movement routines tailored to extremely low energy levels
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Help you understand side effects of rasagiline more clearly
Which direction would you like to go:
GP summary, fatigue strategies, or chair‑based movement?
I am 72, live alone & was diagnosed with Atypical Parkinson’s 3 years ago following a positive datscan. I was placed on Sinemet which is like Madopar & Rasagiline. My troublesome symptoms are gait freezing, balance issues, breathlessness & fatigue. I also cannot walk far.
I saw a Neurologist who specialises in Parkinson’s about 9 months ago. He questioned whether I do have “Parkinson’s”. So I have stopped taking my medication with his approval. I am no better & no worse. It is likely that I do have one of the many “Parkinson’s“, but not one where medication helps me with my symptoms. I do have other health issues which complicates things.
Any questions do ask. All the posters here are kind & helpful & most don’t bite apart from “Tot“, {who is lovely}. She is one of the best posters here.
Best wishes
Steve2
I think you might consider seeing a specialist Parkinson’s neorologist. It costs about £300 & is worth every penny in my opinion.
Steve2