Can My Mother Restart Madopar for Parkinson's Symptoms?

Q: Can My Mother Restart Madopar for Parkinson's Symptoms?

Hello： It is advisable to continue the medication, starting with a low dose, such as 0.25 to 0.5 pills three times a day, and then observe if there is any improvement in gait. <br>Additionally, it may be necessary to clarify the reasons why your mother was previously reluctant to

Parkinson's disease

Hello Dr.
Hong, my mother is 78 years old and has been diagnosed with Parkinson's disease and dementia for 5 years.
Initially, she was prescribed Madopar 250, taking one tablet three times a day, but she only took it for about a month.
After that, she decided to stop taking it on her own and has not resumed since.
Currently, she is only taking Mirapex PR 0.375 mg once a day.
Recently, she has been experiencing difficulty walking and body stiffness.
Can she restart taking Madopar to help improve these symptoms? Thank you.

Cathy, 50~59 year old female. Ask Date: 2021/12/19

Dr. Hong Weibin reply Neurology

Hello: It is advisable to continue the medication, starting with a low dose, such as 0.25 to 0.5 pills three times a day, and then observe if there is any improvement in gait.
Additionally, it may be necessary to clarify the reasons why your mother was previously reluctant to take the medication—was it due to side effects? Starting with a low dose may help minimize any noticeable side effects.

Reply Date: 2021/12/19

More Info

Your mother's situation is quite complex, given her dual diagnosis of Parkinson's disease and dementia. It’s understandable that you are seeking ways to improve her quality of life, especially with the recent increase in her mobility issues and stiffness.
Madopar, which contains levodopa and benserazide, is commonly used to treat the symptoms of Parkinson's disease. It works by replenishing the levels of dopamine in the brain, which is typically deficient in individuals with Parkinson's. If your mother had previously taken Madopar and experienced some benefits, it may be worth considering a reintroduction, especially since her current medication, Mirapex (pramipexole), may not be providing sufficient relief for her symptoms.

Before making any changes to her medication regimen, it is crucial to consult with her healthcare provider. They can assess her current condition, review her medical history, and determine if restarting Madopar is appropriate. Factors to consider include her overall health, any potential side effects she may have experienced previously, and how her dementia may affect her response to the medication.
In addition to medication adjustments, there are several supportive strategies that can help manage her Parkinson's symptoms:
1. Physical Therapy: Engaging in physical therapy can help improve mobility, balance, and strength. A physical therapist can tailor exercises to her specific needs and abilities.

2. Occupational Therapy: An occupational therapist can assist in modifying her environment to make daily tasks easier and safer, which can enhance her independence.

3. Regular Exercise: Encouraging gentle exercises, such as walking or stretching, can help alleviate stiffness and improve overall mobility. Activities like tai chi or yoga can also be beneficial.

4. Nutrition: A balanced diet can support overall health. Ensuring she stays hydrated and receives adequate nutrition can help maintain her strength and energy levels.

5. Routine: Establishing a daily routine can provide structure and help reduce anxiety, which can be particularly beneficial for someone with dementia.

6. Cognitive Stimulation: Engaging her in activities that stimulate her mind, such as puzzles, reading, or memory games, can help maintain cognitive function.

7. Support Groups: Connecting with support groups for caregivers and families of individuals with Parkinson's and dementia can provide emotional support and practical advice.

It’s also important to monitor her symptoms closely. If she experiences any new or worsening symptoms, or if her current medication regimen does not seem effective, it’s essential to communicate this to her healthcare provider. They may need to adjust her medications or explore other treatment options.

In summary, while it may be possible for your mother to restart Madopar, this decision should be made in consultation with her healthcare provider. They can provide guidance based on her specific health needs and ensure that any changes to her medication are safe and appropriate. Additionally, incorporating supportive therapies and maintaining a structured routine can significantly enhance her quality of life.

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