Drug interactions

[Kat Ward <kjward@xxxxxxxxx>]

Dear List,
    My name is Kathryn Ward and my father has Parkinson's. He is 68 years old 
and was diagnosed in 1996. He was coping as well as to be expected given the 
added burden of macular degeneration and retinal detachment in one eye. He 
became a candidate for DBS and in April 2001 had one stimulator successfully 
implanted. During the past month he has been experiencing  fairly severe 
"spells" of dizziness, nausea, extreme dry mouth, flushing of his upper body, 
confusion, lightheadness, muscle pain and weakness, abdominal pain, loss of 
appetite and weight loss and erratic blood pressure. These "events" had been 
occurring prior to the neurosurgery but they were not as severe as they have 
become in the past month. Every one in his medical community seems stumped by 
these symptoms ( which appear to read like the side effects of Sinemet ) and 
last month his neurologist told him that these symptoms were not symptoms of 
Parkinson's.
    He has since been to the cardiologist and been tested ( Negative on all 
counts-- the cardiologist told him that he thought it WAS Parkinson's) and two 
weeks ago he was in the local ER for five hours because his BP was so high that 
my mother was fearful of an aneurysm and called 911. Again nothing was 
uncovered to account for these mysterious "spells" which came and went all day 
long, some being more severe than others but always knocking him down and 
keeping him from leaving the house. He has even had an abdominal CT which also 
was clear of abnormalities.
    I live 300 miles away from my parents and tried to get my mother to really 
keep track of when the spells were happening and what he was doing, had eaten, 
timing of meds etc. but she is so overwhelmed that I wasn't able to get much 
help there. I have been to see my father twice in the last two weeks and have 
observed what is going on. I began to really question the combination of his 
meds. He is taking Sinemet, Hytrin and Valium. All three have almost the same 
side effects-- especially the Hytrin and Sinemet. My research is leading me to 
strongly suspect a negative synergistic effect caused by the combination of 
these three meds. The Hytrin was prescribed over a year ago by a urologist for 
enlarged prostate and the Sinemet and Valium were prescribed by the 
neurologist. My sister and I have both read that Valium can interfere with the 
action of Sinemet.
     My father re-visited the neurologist two days ago ( and my sister went 
along with my parents to ask questions ) and the only thing the neurologist 
could offer at this point was that the symptoms are indeed Parkinson's moving 
into Stage 4. When questioned specifically about the possibility of a negative 
drug interaction he was noncomittant and suggested that my father see the 
neurosurgeon and get a second stimulator and told Dad to make his next 
appointment for a month from now. When asked why the Valium was prescribed for 
my father the neurologist said to help Dad "relax" and gave no indication that 
taking Valium and Sinemet at the same time was a problem in his mind. (Needless 
to say, we are not pleased with this treatment but right now our primary 
concern is Dad's condition.) I am hoping that someone on the List can shed some 
light on these mysterious symptoms...are they "just Parkinson's getting worse" 
or are they indeed indicative of a drug toxicity? I'm pretty sure from research 
and observation that the Sinemet alone isn't causing these symptoms. Is there 
anyone taking Hytrin and Sinemet or Valium and Sinemet or all three 
medications? Is anyone having similar kinds of "spells" as simply a part of 
Parkinson's? Has anyone else had a stimulator implanted and experienced these 
symptoms? ( I tend not to suspect the stimulator because immediately after the 
implant the tremors and arm/leg waving that Dad was experiencing stopped and he 
looked and felt really well, but I have to look at all the issues).
 Any information or suggestions from the Parkinson's Community will be 
appreciated greatly.
Thank you
Kathryn Ward

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