Urinary Dysfunction and No Sleep at all


#1
Hello,

Following on from my previous post on the Meet and Greet forum (16/8/2011) regarding my Dad taking the medication Memantine things have got further downhill.

Dad is now not getting any sleep at all at night, and is up at least every hour with an urge to go to the toilet. Results back from the doctor have found no problems or infections so it points back to a direct symptom of Parkinson's. I had put on my previous post that this problem of no sleep and urinary dysfunction had increased dramatically since he was prescribed the memantine medication to aid in the symptoms of Dementia he has developed. The side effects of this drug (I and my Mother feel) have got us to this stage, as I cannot accept that he could deteriorate so bad within the space of just two weeks (coincidentally the same two weeks he was taking this medication). We have now withdrawn him from taking this medication as it was not providing any help to the symptoms of dementia but making him more confused.

Unfortunately he has now started to become very very agitated at times and yesterday said he wanted to die and did not want to carry on. :cry: A few hours later he could not recollect saying this. This increased spell of agitation, depression and no hope is getting worse... I just don't know what to do and feel so helpless... especially knowing that my mum is up all night with him..

As I type this my Mum in despair has rung his consultant and based on an appointment with the consultant last week and these further events the consultant is now of the opinion that the issue of Dad wanting the toilet every hour is a result of Compulsive Behaviour? Has anybody else had any experience of this? I am aware of compulsive behaviour, and to date he had no issues of gambling.

Dad's GP has in the meantime prescribed temazepam - but Dad is adamant he is not taking the tablet. When I read the side effects of this drug they seem just as scary. Is it worth the risk and would it be beneficial so he and Mum can get some sleep at night? :question:


Thank you for taking the time to read this...I appreciate any comments/suggestions or feedback

#2
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Hi Christopher.

Compulsive behaviour is covered at great length in the "Treatments" section, and in particular in the thread entitled "Dopamine Agonists ("DAs") and catastrophic Obsessive/Compulsive Disorders" ("OCDs"), initiated by myself on 26 May 2011.

PD drugs in the DA class appear to be by far the worst in triggering such behaviour, and there are scores of different obsessions on record, all verified, which DAs have caused. Here is a recent list:

Gambling
Excessive lifestyle
Shopping
Hyper spending
Reckless generosity
Hypersexuality
Extramarital affairs
Suspicions of partner’s infidelity
Cross dressing
Pornography (inc child pornography)
Prostitution use
Fetishism (e.g. bondage, masochism, sadism, paraphilia)
Sexual reorientation
Obsessive masturbation
Frotteurism
Exhibitionism
"Flashing"
"Peeping Tomming"
Paedophilia
Zoophilia
Visual hallucinations
Obsessive risk-taking
Punding
Delusions (e.g. grandeur, paranoia)
Threats of violence
Violence
GBH/ABH/Disfigurement
Murder
Self harm
Suicides & attempts
Massive creativity change
Singing
Eating

Most affected patients suffer from one compulsion initially, and then more come along. Compulsions usually get worse when doses are increased. Most sufferers become secretive, devious and aggressive, and deny everything - usually blaming the accuser and claiming there ISN'T a problem.

24% (1 in 4) of PD patients prescribed DAs suffer from OCDs to some degree. These are the latest confirmed research figures, published February 2011.

I have personally had a lot of involvement with DAs and OCDs over more than a decade, and I can honestly say that I have NEVER heard of toilet functions being affected as a result of DA-related OCD behavioural/personality changes.

It is possible that your consultant may be grabbing at straws somewhat.

Regards,

Ray.
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#3
A few months before dx I developed urinary urgency, feeling the urge to go at ridiculously short intervals which became really troublesome. I was prescribed a course of Tolterodine tartrate (Detrusitol) and it did the trick.

#4
Hello Eileenpatricia,

Thank for your post - we will see if Dad can get this medication to help him as nothing has been suggested to date and you have given me hope. :smile:
Can I ask if the urge for needing to go the toilet occurred more often at night? The problem for Dad seems to be more often throughout the night..


RayofSunshine - thank you for your very informative reply. Whilst scary to read of the potential OCD's I tend to agree with you the suggestion that the need for the toilet is such a OCD. Surely if this was the case it would happen at all times during the day and not just at night? Do you think the would benefit him sleeping at night as he is just to anxious, agitated and worked up during the night hours. :question:

Thank you both again.

#5
I wonder whether this is more the case of an overactive bladder. My husband suffers from this - the more he goes the more he thinks he wants to go. It doen't happen all the time and is more likely to happen at night or first thing in the morning.

I would caution against the drugs used to combat this - I was told by our Urinary Nurse Specialist that they do not mix well with PD drugs in that they affect the same part of the brain. I'm afraid my memory of the details is a bit vague.

However you could ask to be referred to a Urinary Nurse Spec. and/or to an incontinence nurse.

I feel for your Mum - my husband does get me up intermittently and we have some nights that are really bad but it doesn't sound anything like as bad as what is happening with your Dad.

I'm sorry I can't offer more practical help.

Thinking of you and your Mum.

Worrals

#6
Hi Christopher,

I had similar problems and found it very uncomfortable, painful and depressing. In my case it was the drugs I was on and timings. Once my drug regime was reviewed I gained control of my bladder again. As a test for urinary infection been carried out? Infection can cause terrible confusion.

I hope the following information is of use to you.


[u]Urge incontinence[/u]
An overactive bladder is caused when messages from the brain telling the bladder to wait aren’t getting through properly.

Instead of being able to spend time finding a toilet, a person will feel the need to go immediately. If a toilet isn’t reached in time, the person may not be able to control their bladder. This is called incontinence.

[u]Nocturia[/u]
If you have an overactive bladder you may also feel the need to urinate more often than before. This may wake you up at night, or your bladder may empty while you are asleep.
Speak to your GP, specialist or Parkinson’s nurse (if you have one) if you are experiencing these problems.

For more information please see the following link
http://www.parkinsons.org.uk/pdf/B060_bladderandbowels.pdf

Best regards
Cutiepie

#7
Tolterodine Tartrate “Indications: urinary, frequency, urgency and incontinence”
If you google it lots of info.turns up including lists of specific drugs it should not be taken with.

I don’t remember whether there was greater frequency at night, bearing in mind I am of an age when all of my friends find themselves getting up in the night. Probably something to do with sleeping lighter although I sleep pretty well. But the sensation of irresistible urge to go was the worst I had ever experienced and could be a little as a quarter of an hour after the last trip to the loo with urinary infection ruled out. Any urgency needs sorting out as if you go when the bladder is not full, your bladder will actually be able to hold less and less.

#8
Thank you everybody for your comments - very helpful and informative.

Christopher23