Medications to help with fatigue and brain fog
I’m a 76 year old woman who has had PD for about two years now. The most problematic issues I’ve experienced are fatigue and brain fog/fuzziness. I also have some tremors. I was on Sinemet for several months, but it caused dyskinesia. I also tried Rasagiline for a couple of months, but did not find it helped. I also tried LDN (low dose Naltrexone) for 3 months. I am not sure if this helped. I recently started taking a very low dose of Sinemet again to try to help with the tremors, etc. I have attended Rock Steady Boxing in the past and hope to get back to those classes. My questions are:
1 - Has anyone found anything that has worked to reduce fatigue or brain fog?
2 - Has anyone tried LDN, and if so, what results have you experienced?
3 - Does anyone have positive experiences with any alternatives to Sinemet?
4 - Has anyone tried HIFU/MRgFUS for PD Tremors?
5 - Has anyone tried the experimental glove treatment for tremors?
Thank you!
, These are great questions. I have been fortunate to have success with sinemet although I have experienced some dyskinesia. As far as brain fog, I think (just my experience and education - not a physician) several factors besides meds may be involved. I take rasagiline and ropinirole with sinemet and have not experienced brain fog. It sounds like you exercise, which is good. Do you do any brain games or such? I don’t know how well hydrated you are or if you sleep well. Fatigue and brain fog seem to relate to each other. Have you been able to nap if you don’t sleep well at night? I don’t have experience with the other meds or the glove. I hope you find some relief. My best to you, Lorraine, parkinsonsdisease.net moderator 
Lorraine Wilson provided some excellent insight into how you may be able to counteract brain fog which I have not experienced. However fatigue is frequently a problem for me. My movement disorder specialist suggested napping for 30 to 45 minutes once a day and if I wake feeling refreshed that is a good thing. Hydrating also is very important in keeping refreshed by taking small sips throughout the day. I don’t have experience with the drugs you mentioned or the glove. Perhaps another community member will join the conversation who has more experience. I hope you can find a solution soon.Stay in touch and let us know how you are doing. Thea DeStephano Community Team
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I take 100mg Modafinil tablets daily to stay awake, if this is what you mean by reducing brain fog and fatigue. Without them, I could take multiple naps, as I proved when I did the sleep study to prove that I needed to be prescribed this medicine. I have not had any side effects, and because of them, I am able to stay awake all day and be functional. That said, there is a small wait to get them since they are considered "controlled." Once you get them, you're set until the next time you need to go talk to the respiratory doc to make sure all is well with them and you. There is no need for blood tests with them as well. I'm definitely glad they're a part of my routine and have been for a few years.
I had rasagaline before lev / car. I take it now in combination with lev / car. It doesn't seem to be hurting anything, but as it's part of a package, I'm not sure it helps (though I'm not sure it doesn't help - if that makes sense). My experiences with lev / car are a lot of dystonia and diskinesia, a fair bit of off time. Hence, I'm moving to DBS in September (a diversion from the world of focused ultrasound, which I had too many tremors on BOTH sides to qualify for). Focused ultrasound has a lot of positives, but if both your hands are going, you will find FUS only works on 1 side. The other side gets fixed with DBS. I chose DBS because FOR ME there was no point to do 1 and then do the other anyway. I found the doctors at Penn Medicine in Philadelphia were and are very knowledgeable / competent with this, and they have left me relieved to moved toward DBS. I don't say that lightly since DBS is a big obstacle for me. Nevertheless, I go forward confidently.
