New CLIMB locations starting soon!
Cameron Hospital located at 416 East Maumee St. Angola, INwill be starting classes July 23rd. Classes will be held Mondays
and Wednesdays from 3:30-4:30pm. Cost of the classes will be
$50/month. Please contact Joell at 260-667-5163 for more information.
Stonecrest of Meridian Hills located at 8549 Meridian St. Indianapolis
will be starting classes July 24th. Classes will be held Tuesdays and Friday at 1:00pm. Please contact Mary Ellen at 317-253-2020 for more information.
SUPPORT GROUPS
Caregiver Support Group:
July 30th from 11:15am -12:45pm at Wild Eggs in Fishers. Open Discussion
Support Group:July 25th at LivRite Fitness in Noblesville from 12:15pm-1:00pm. The speaker will be Kindred Hospice.
Greenwood Support Groups:
P.D. Support Group every 3
rd Tuesday of the month at 3:00pm. The support group is held at Mt. Pleasant Community Life Center (1
st floor meeting room).
Caregiver Support Group Every 2
nd Saturday of each month at 10:45am. This group is held at Mt. Pleasant Community Life Center (1
st floor meeting room).
Westminster Village North Support Group:Every month on Tuesday from 2:00pm - 3:00pm and Thursday from 10:00am -11:00 am at Westminster Village North located at 11045 Presbyterian Dr. Indianapolis (317)823-6841.
2018 Choose to Move will take place Saturday September 15th at Witten Park located at 13256 Saxony Blvd. Fishers. There is a 5k run and 1mile fun run/walk.
Make a difference today! Choose to Move has become an important and successful fundraiser for the Indiana Parkinson Foundation. Your support will help us serve more people with Parkinson's Disease.
In addition to registering for the event, you can rally your friends and family by starting your own fundraising team to help us reach our goal. Every donation makes a difference and is fully tax-deductible.
Indiana Parkinson Foundation PicnicJuly 22nd at 5:00pm
Ginger's Cafe 1804 Conner St Noblesville, IN 46060
Ticket are $12.00 per person
Call 317-550-5648 with questions.
Ladies LunchJuly 31st at 12:30pm
Jason's Deli 11621 Fishers Station Dr. Fishers, IN 46038
Call 317-550-5648 with questions.
Educational Talk on Neurogenic Othostatic HypotensionAugust 16th at 9:00am
Community Health Pavillion 9669 E. 146th St. Ste 160 Noblesville, IN
A Doctor and patient advocate will be speaking with breakfast provided.
Call 317-550-5648 to attend.
Partner Events:
Women with Parkinson’s Disease: Stronger Together
Open to all women interested in learning more about Parkinson's Disease
Saturday July 28th from 9am-4pm.
Hosted in cooperation with PAACI at Northside Knights of Columbus
2100 East 71st St. Indianapolis. For more information call or email Linda Hinkle 317-374-4201 hinkle.l@sbcglobal.net or Deb Williams 317-698-7539 debslp47@aol.com
PAACI Fall Parkinson Symposium.When: September 8thWhere: Northside Knights of Columbus 2100 East 71st IndianapolisContact: Sheri 317-255-1993
Come out and be connected with a larger Parkinson's community and learn more about Parkinson's disease. Dr. Joanne Wojcieszek, movement disorder specialist, will be the keynote speaker.
Caregiver's Retreat:Joy's House has their final retreat August 25th from 9a –12 p at Copper Trace Senior Living Community. Mark your calendars and contact Candace Preston at 317-254-0828 if you are interested in attending.We would like to thank those in our community who help us with our programs and services: LivRite Fitness, Wild Eggs in Fishers, The Knights of Columbus for hosting our annual breakfast, Jeri Stortzum from 1st Care Home Health Services and Lona Newton with Senior Living Advisor.
Have a safe and happy holiday from
The Indiana Parkinson
Foundation.
BOOKS TO READ
Navigating Life with Parkinson's Disease By: Sotirios Parashos
Parkinson’s Disease: 300 Tips for Making Life Easier By: Shelley Peterman Schwarz
Understanding Parkinson's Disease: A Self Help Guide By: David Lee Cram & Steven Schechter
HallucinationsBy Kelsey McClymonds
Hallucinations and Parkinson’s Disease
How common are hallucinations in PD? Hallucinations and Parkinson’s psychosis is estimated to occur in up to 50% percent of Parkinson’s patients.
What kind of hallucinations do PD patients experience? Nearly all hallucinations that Parkinson’s patients experience are visual hallucinations. Auditory hallucinations are very rare in Parkinson’s disease however they can occur. When they do occur, they are commonly in conjunction with visual hallucinations. Common themes of the delusions are typically of spousal infidelity. Other common themes cause people to become paranoid in nature for the duration of the hallucination. Paranoia hallucinations include the patients thinking people are out to steal from them, people are trying to put poison in their food or harm them, or replace their Parkinson’s medications. It is very important that immediate actions are taken for the paranoia hallucinations as some PD patients have called 9-1-1 to report the false reports.
What causes the hallucinations? Researchers and doctors are still not positive on what exactly causes the hallucinations in Parkinson’s disease. However, some researchers now believe that psychosis in PD is due to long term use of parkinsonian medications. Dopaminergic and anticholinergic drugs are especially found to be a likely cause of the hallucinations. Through this research a “continuum hypothesis” has been created. This hypothesis states that “medication-induced psychiatric symptoms in Parkinson’s disease starts with sleep disturbances accompanied by vivid dreams, and then develops into hallucinations and delusions and ends in delirium.” (Movement Disorders & Neurorestoration Program, Okun) The link to the medications has been established due to the notion that research shows that psychotic symptoms are related to high levels of dopamine and in PD patients this is often a result of their medication since the nature of the disease is that patients have extremely depleted levels of dopamine in the substantia nigra. Thus the hallucinations are most commonly a side effect of the medications that they take.
How can the hallucinations be managed? Some antipsychotic drugs can be used to treat this symptom, however, it is warned to be careful with this method of treatment for hallucinations as some antipsychotic drugs are harmful to Parkinson’s patients and have the potential to make the hallucinations or delusions worse. Other methods of managing the psychosis is that your doctor may first reduce or change the PD medication that you are taking to see if that reduces the psychotic symptoms. This method requires you and your doctor finding a balance between the treatment and the side effect of the drug. PD patients need higher levels of dopamine to help control the motor symptoms however the dopamine levels can’t be so high because that can cause the hallucinations and psychosis.
MEDICATION THAT SHOULD BE AVOIDED WITH PARKINSON'S DISEASE:
Source, APDA website. The manufacturers of these medications may not list Parkinson’s disease as an absolute contraindication; however, better choices within a medication class may be suggested. Some of these medications alter the brain ‘s dopamine system causing an increase in Parkinson’s symptoms, others may chemically interact with Parkinson’ s medications and cause side effects. This is not intended to be a complete list and additional brand names may occur for each medication. If you have any questions about this list, please talk to your physician or pharmacist.
Medication---------Chemical----------------------Brand----------------------Interaction Older Antipsychotics (used to treat behavioral disorders)
| Chlorpromazine Fluphenazine Haloperidol* Loxapine Thioridazine Thiothixene Trifluoperazine Pimozide
| Thorazine® Prolixin® Haldol® Loxitane® Mellaril® Navane® Stelazine® Orap
| | Block dopamine receptors in the brain, worsening PD symptoms
|
Antiemetics (used to treat nausea or vomiting)
| Chlorpromazine Droperidol Metoclopramide Prochlorperazine Promethazine
| Thorazine® Inapsine® Reglan® Generics® Generic
| | Block dopamine receptors in the brain, worsening PD symptoms
|
Medication------------ Chemical------------name-------------Interaction Antihypertensives (used to decrease blood pressure)
| Reserpine
Methyldopa
| Serpalan®
Aldomet®
| Decrease dopamine stores and activity, worsening PD symptoms
|
Antidepressants (used to treat depression)
| Phenelzine Tranylcypromine
| Nardil®
Pamate®
| Inhibit monoamine oxidase. Should not be taken in patients receiving levodopa, may increase blood pressure, fever, or agitation
|
Antidepressants (used to treat depression)
| Amoxapine
| Generics®
| Block dopamine receptor
s in the brain, worsening PD symptoms
|
Note: There may be additional brand names for each medication. This is not intended to be a complete list. * The package insert for Haldol® (haloperidol) lists use in patients with Parkinson’s disease as a contraindication
Medications that should not be taken with
Selegiline HCL (Eldepryl, Deprenyl, Zelapar) and Rasagiline (Azilect)
Medication------------Chemical Name------Brand name Narcotic/Analgesic
| Meperidine
Tramadol
Methadone
Propoxyphene
| Demerol®
Ultram®
Dolophine®
Darvon®
| |
Antidepressants
| Mirtazapine
St. John’s Wort
| Remeron®
Several Brands
| |
Muscle Relaxants
| Cyclobenzaprine
| Flexeril®
| |
Medication------------------------------------------Chemical----------------------Brand Cough Suppressant
| Dextromethorphan
| Numerous Brands
|
Decongestants/ Appetite Suppressants (found in cough, cold, allergy, and sinus medicines)
| Pseudophedrine Phenylephrine
Ephedrine
| Sudafed®
Sudafed PE®
|
| | |
Note: There may be additional brand names for each medication. This is not intended to be a complete list. Using these agents with selegiline or rasagiline increases the risk of one or more of the following: high blood pressure, increased heart rate, respiratory depression, seizures, tremors, fever, confusion, or behavior changes.
Medication classes that should be discussed with doctor or pharmacist
Newer Antipsychotics: Clozapine (Clozaril) and quetiapine (Seroquel) have the least risk of worsening Parkinson symptoms and are the treatments of choice for drug induced hallucinations and psychosis.
Antidepressants: Some agents within this class may worsen PD symptoms, increase confusion, or interact with some of your PD medications.
Antihistamines: These are found in cough, cold, allergy, and sleep medications. When taking these medications, the elderly are at an increased risk of the following side effects: blurred vision, confusion, constipation, urinary retention, and dry mouth. The newer antihistamines loratadine (Claritin®) and desloratadine (Clarinex®) may have less side effects than older antihistamines. Cetirizine (Zyrtec®) may or may not have less risk. Topical eye or nose sprays/drops have the least risk of these side effects.
Non-prescription medications and supplements: Some of these agents may interact with PD medications. They may not be contraindicated; however, an adjustment in the timing of the medication may be needed. For example, iron supplements may decrease the absorption of levodopa and these medications should be spaced as far as possible.
The above tables were compiled by Maria Tan, Pharm .D. candidate and Mary Wagner, Pharm.D., MS Ernest Mario School of Pharmacy at Rutgers, the State University of New Jersey.
The information contained in this supplement is solely for the information of the reader. It should not be used for treatment purposes, but rather for discussion with the patient’s own physician.
For additional free copies of this supplement, please call or visit the website AMERICAN PARKINSON DISEASE ASSOCIATION (800) 223-2732 • www.apdaparkinson.org © Copyright APDA, Inc. Reprinted August 2016