Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

24 recordings of night-time sleep in three patients suffering from progressive supranuclear paralysis were carried out. There was observed: a tendency to insomnia, disappearance of spindles, an invasion of slow sleep immediately it appeared by the muscular and ocular criteria of paradoxical sleep, a considerable reduction in paradoxical sleep in the strict sense of the term, the latency of which in making its appearance was, however, maintained; progressive invasion of the paradoxical phases by slow waves. These abnormalities differ from those found in Parkinson's disease.
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PMID:[Sleep disorders in Steele-Richardson disease. Polygraphic study of 3 cases]. 18 12

Despite some evidence that neuroleptic medication is overused or misused in long-term care facilities for the elderly, there has been virtually no attention paid to the pattern of use of antidepressants in these facilities. All patients in long-term care in a geriatric hospital and a home for the aged who were receiving antidepressants were identified; 10.5% of the patients in the hospital and 12.7% in the home for the aged were receiving an antidepressant. The rate of use of antidepressants on the different units ranged from 0% to 26.8%. The most commonly prescribed antidepressant was doxepin followed by nortriptyline. The mean dose of antidepressant was 34.8 mg. Although depression was the most common reason for the prescription of an antidepressant (69% of patients receiving one), other reasons included pain, agitation, aggression, and insomnia. Patients had been receiving antidepressants for up to 10 years, with a mean duration of 32 months. The majority of patients (60%) had a history of depression predating their institutional admission. Patients receiving antidepressants were compared to a group not receiving antidepressants, who were matched for age, sex, unit, and attending physician. Patients receiving antidepressants were more likely to have a history of stroke (33.8% versus 16.9%). There was no significant difference between the two groups regarding the prevalence of dementia, Parkinson's disease, thyroid disease, malignant tumor, congestive heart failure, or diabetes mellitus. Prospective studies are required to determine the efficacy of antidepressants in this population and to identify factors that can predict a positive response to treatment.
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PMID:Pattern of use of antidepressants in long-term care facilities for the elderly. 141 68

Selegiline (deprenyl) is a selective inhibitor of cerebral monoamine oxidase type B at the dosage (10 mg/day) used in patients with Parkinson's disease. Through this activity, the drug increases nigrostriatal dopamine levels, and may protect neurons against damage by free radicals and possibly exogenous neurotoxins. Selegiline also inhibits dopamine reuptake from the synaptic cleft. Because of its selectivity, selegiline 10mg daily does not prevent the breakdown and exacerbate the indirect pressor effects of dietary amines such as tyramine; it is devoid of the 'cheese' effect. Following oral administration, selegiline is rapidly metabolised to L-methamphetamine and L-amphetamine, which may account for the euphoria and insomnia seen in many patients, although potentiation of dopaminergic activity with concurrent levodopa appears more likely. The drug is a useful adjunct to levodopa in Parkinsonism, improving 'end-of-dose' fluctuations, producing modest improvements in motor function, and allowing a reduction in levodopa dosage. Indeed, if levodopa dosages are not decreased when selegiline is added to the therapeutic regimen, peak concentration dyskinesias due to levodopa are often exacerbated. However, symptomatic benefits are rarely maintained for more than a year and selegiline is relatively ineffective in allaying the abrupt swings in response to levodopa ('on/off' effects). When used alone in patients with mild disease, selegiline appears to slow the rate of symptom progression and may extend survival, through either neuroprotection or symptom relief. Whichever mechanism(s) is responsible, there is strong evidence to suggest that selegiline should be considered both in patients newly diagnosed with Parkinson's disease in an attempt to delay symptom progression, and in those experiencing dose-dependent fluctuations in response to levodopa.
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PMID:Selegiline. A review of its pharmacology, symptomatic benefits and protective potential in Parkinson's disease. 179 16

Fifty Thai patients with Parkinson's disease of all staging were allocated for 10 mg/day L-deprenyl therapy as the monotherapy (6 patients) and adjunctive therapy for at least two months. The assessment of this open study included the activities of daily living using Schwab/England Scale, Hoehn and Yahr staging and Unified Parkinson Disease Rating Scale (UPDRS) by comparison of the initial and after two month of treatment scores. There was improvement of both Schwab/England Scale and UPDRS in Hoehn and Yahr stage I, II and III patients. In stage IV and V patients there was no benefit of L-deprenyl therapy of both clinical and statistical analyses. Adverse effects of L-deprenyl were not serious. There were dry mouth (20%), anorexia (10%), nausea and vomiting (8%), insomnia (6%), lightheadedness (4%) constipation (4%), abdominal pain (2%), generalised ache (2%). We conclude that L-deprenyl therapy is effective, safe, but costly. It is more effective in early Parkinsonism. The effectiveness of L-deprenyl is less in more advanced states of Parkinson's disease. Thus, selection of the appropriate Parkinsonian patient for L-deprenyl therapy is vital.
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PMID:L-deprenyl therapy in Thai patients with Parkinson's disease: before and after, clinical trial of 50 patients. 212 33

Previous investigators have suggested that numerous symptoms used to diagnose depression, such as sleep or appetite disturbance, are non-specific in medically ill patients, and alternative diagnostic criteria should be developed. In the study this hypothesis was tested in Parkinson's disease (PD) by comparing patients with PD who reported a depressive mood with patients having PD but without a depressive mood. Depressed patients showed a significantly higher frequency of both autonomic and affective symptoms of depression. Depressed patients with PD reported a significantly higher frequency of worrying, brooding, loss of interest, hopelessness, suicidal tendencies, social withdrawal, self-depreciation, ideas of reference, anxiety symptoms, loss of appetite, initial and middle insomnia, and loss of libido when compared with non-depressed patients. No significant between-group differences, however, were observed in the frequency of anergia, motor retardation, and early morning awakening.
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PMID:Specificity of affective and autonomic symptoms of depression in Parkinson's disease. 226 68

Practically all drugs administered in large amounts can give rise to neurologic symptoms such as drowsiness, insomnia, confusion, seizures or coma and extrapyramidal disorders. In this study, five classes of agents are reviewed: antipsychotic drugs, drugs for Parkinson's disease, antiepileptic drugs, calcium antagonists and salts of bismuth.
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PMID:[Various encephalopathies caused by drugs]. 256 72

We studied sleep patterns for three nights in 10 subjects with moderate to severe progressive supranuclear palsy and correlated the findings with disease severity using quantitative measures of motor, cognitive, and eye movement impairment. All subjects had severe insomnia, spending 2 to 6 hours awake per night; the mean time awake per night for the group was more than 4 hours. Sleep latency became shorter and the number of awakenings increased with greater motor impairment, and total sleep time declined as dementia worsened. These findings indicate that in progressive supranuclear palsy insomnia is related to disease severity. Insomnia associated with progressive supranuclear palsy appears to be worse than the insomnia of Parkinson's disease or Alzheimer's disease and may be due to degenerative changes in brain structures responsible for sleep maintenance.
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PMID:Sleep abnormalities in progressive supranuclear palsy. 274 60

A study of neurological disorders and services is presented. The ten most common neurological diagnoses were headache, back disorders, neuropathy, cerebrovascular disease, dizziness/insomnia, myopathies, soft tissue disorder, intracranial injury, neurological symptoms (numbness, etc.), and Parkinson's disease. The pattern of diseases is similar to that reflected in the prevalence of those in the US. The annual beneficiary rate was 1.6% of the population, the median age was 45 years, and the majority (52%) served were females. There were 1.8 annual services per beneficiary and the median hospital stay was 9 days. Ambulatory care accounted for the majority (62%) of services and 64% of the inpatient services were delivered by neurosurgeons. The majority of the admissions (61%) and of the ambulatory services (55%) were provided in Regina.
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PMID:Neurological disorders and services in Saskatchewan--a report based on provincial health care records. 326 99

1. Insomnia is an even more frequent complaint in elderly patients with Parkinson's disease than might be expected from the effect of age alone on sleep. 2. A double-blind, placebo-controlled trial in eleven patients with Parkinson's disease of mean (s.d.) age 80(5) years, showed that nocturnal dosing with levodopa produced a clinically significant improvement in sleep both as assessed subjectively and by measurement of number of spontaneous moves in bed. 3. Despite the long interval between tablet administration and morning assessment, walking time was faster on mornings following active treatment.
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PMID:Parkinson's disease in the elderly: response to and optimal spacing of night time dosing with levodopa. 332 92

Several pharmacologic agents provide antihistamine effects by acting at the H1 histamine receptor site. The classic agents are relatively nonselective, resulting in a wide range of effects, both therapeutic and undesirable. The newer agents preferentially block peripheral H1 receptor sites and, consequently, have fewer side effects, including sedation. Antihistamines are useful in the treatment of allergic conditions, Parkinson's disease, insomnia and some forms of nausea, and provide symptomatic relief of cough and other conditions associated with respiratory tract infections. Certain agents may play a role in the treatment of asthma and anorexia. Selection of a specific agent should be based on cost and the minimization of side effects. The classic antihistamines provide an inexpensive and highly effective means of treating histamine-mediated symptoms. The bothersome central nervous system side effects can be alleviated by taking the drugs at bedtime; their prolonged tissue half-life allows dosing once or twice a day for 24-hour clinical relief. The newer, more expensive nonsedating antihistamines are acceptable alternatives for patients who are incapable of tolerating the effects of classic agents.
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PMID:Antihistamines: the old and the new. 762 32


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