Help / Comments on drug combination

Hello everyone

My brother aged 72 has had Parkinson's for quite a few years and the last year it has got much worse. For much of the day he is virtually comatose and unable to move. For a couple of hours at a time he is OK, lucid and able to get around. He has frequent accidents during the day and night due to his inability to make it to the toilet in time - his 82 year old wife is at her wits end. I have started to look into the drugs he takes and have noticed that they have hardly changed over the last year and have requested a review with the PN. Currently Frank takes the following: I will leave out his Blood Pressure and diabetes medication..(perindopril, Metformin and Doxarosin)


Sastravi 75/18.75/200 - 7 per day spread

Pramipexole 180uG - 5 per day spread

Furosemide (Diuretic) He has some leg swelling and this is the only drug to be adjusted in an attempt to address the nighttime accidents.

After a number of emergency doctor calls, a few months ago Madopar 100 / 25 were added. 2 per day although his wife was told she could add 2 more (afternoon and nighttime) IF needed.  Sometimes they get Frank moving but increasingly often they are having less effect.

Recently his doctor has also prescribed Citalopram which has made no difference.

I realise most on this forum are not medical practitioners but then will have had lots of experience with Parkinson's medications


Any help, suggestions, comments would be most welcolme


Regards to all