I had my 6 monthly meeting with my Parkinson’s Nurse today. It was due to take place a month ago but I caught Covid so it was rearranged for today. I had sent him an email to ask for a referral to the Benenden Hospital where I get to see a Neurologist quicker than the normal NHS route. I think he forgot, he says he will chase it up. He told me that after a 1 week holiday he has over 100 emails to deal with & some do get missed.
At today’s meeting I told him that my walking was worse & my sleeping was worse & that I move violently in my sleep & often hurt my fingers, knees or back during my sleep. It was good that he got to see me at my worst today following a bad nights sleep last night. I struggled to get up from my chair & having done so it was difficult to move my feet. But I managed eventually.
Following a chat with the Hospital’s neurological pharmacist I had stopped taking Bisoprolol [beta blocker] for Afib & put on Digoxin as the Bisoprolol was likely to be the cause of my REM sleep problems. But I was told today that these problems are more likely to be caused by the co-careldopa [Sinemet] Parkinson’s medication
I take.
The Parkinson’s nurse also told me that my walking problems are more likely to be neuropathy based than Parkinson’s.
So he prescribed 3 new pills for me to take. One to combat the REM sleep. One to help me to get to sleep & one to boost the effects of the Sinemet I take.
He told me that I will continually need to increase the amount of Parkinson’s medication I take to gain the same effect.
I also had a chat with the hospital’s neurological physiotherapist & she has made an appointment for me in 6 weeks time to see if the new medication helps me when
I start taking it.
There seems real confusion about what medication I should be taking & what is causing the symptoms I have & whether my troubling symptoms are down to the medication I take. A never ending circle.
It’s good to read that you’ve now had your delayed meeting with the Parkinson’s nurse, hopefully your new prescriptions will have the desired effect.
I was interested in your comment that your nurse(?) felt that Sinemet could be the cause of your sleep problems as about four months ago I was prescribed a Half Sinemet CR 125mg tablet to take at night. The purpose was to enable me to turn over more easily if my hip started to ache and keep me awake. I haven’t noticed any difference in this but I think turning over is all about technique anyway (but if you’re half asleep it’s not easy to work on your strategy…I therefore usually combine turning over with an age-related visit to the bathroom)
The point of all this rambling is to mention that as soon as I started on the Sinemet I stopped waking up from ‘problem’ dreams; where I was in unpleasant and frightening situations that would never happen in real life as I’m too cautious.
Co-incidentally I’ve just emailed my Parkinson’s nurse to suggest upping my Madopar prescription and also mentioned this side effect from the Sinemet and she said it was ‘unexpected’ so perhaps it’s coincidental or just my metabolism?
As an example, beta blocker medications tend to decrease REM sleep, but they are commonly associated with nightmares. Antihypertensives – In one systematic review, beta blockers accounted for one-third of the reports of nightmares as an adverse effect of medications in clinical trials [28].18 Oct 2023
Can Parkinson’s medication cause nightmares?
Medication: Some medications that treat Parkinson’s disease, such as dopamine agonists like levodopa (Inbrija) and pramipexole (Mirapex), can cause more frequent and severe nightmares. RBD: RBD prevents the temporary paralysis that usually accompanies the REM phase of sleep when dreaming occurs.
Nightmares
According to a study in the Journal of Psychopharmacology, apixaban is more likely than other drugs in its class to cause nightmares.
Common side effects of apixaban include insomnia and depression.
Nightmares
Ramipril is an angiotensin-converting enzyme (ACE) inhibitor, and nightmares are a possible adverse effect of ACE inhibitors. While the exact mechanism isn’t known, clinicians should be aware of this potential side effect.
Other neurological and psychiatric side effects
Ramipril can also cause other neurological and psychiatric side effects, including anxiety, depression, insomnia, nervousness, and vertigo
Good afternoon Steptoe … Yes my male, very experienced Parkinson’s nurse said that Sinemet was the most likely cause of my nightmares. I have no active neurologist. This PN prescribed the Sinemet.
The neurological pharmacist at the local hospital said that Bisoprolol [beta blocker] was the most likely cause of my nightmares.
I also take two of the other medications listed above. So what causes my nightmares is anyone’s guess.
I also take a pill that stops me peeing frequently.
