The Right Medication On Time Every Time
One frequently asked question is about managing medication to maximize its efficacy and it goes like this: “Why doesn’t my medication seem to work?” True to its form, Parkinson’s disease (PD) is no stranger to medication mistakes than other illnesses but I’ll keep my comments mainly within the context of PD. Parkinson’s disease is a complex disease that has been referred to before as having multiple symptoms that may seem unrelated but can be tied to PD. These can include respiratory, cardiac, and digestive problems, in addition to related conditions of the nervous system. All requiring different medications to treat them. Sometimes patients are taking a cocktail of multiple medications, in many instances prescribed by a variety of doctors. A gastroenterologist is no substitute for a neurologist. The same can be said about the spectrum of medical specialties. No disrespect to the medical profession but long hours and excessive workloads do not excuse the professional courtesy of a consultation or at least a medication review to assure there aren’t any interactions or contraindications that could actually do harm to the patient. In most medical practices this is protocol.
Common medication mistakes
- Allergies – Again protocol should include what types of medications you are allergic to and list alternatives.
- Follow up – The lack of follow up with your doctor leaves the door open for unanswered questions.
- Questions – You should have a real dialogue with your doctor about what you are taking, what you are taking it for and how it interacts with other medications you are taking.
- Problems – There should be clear instructions on what to do if a prescribed medication isn’t working or adverse effects occur.
- Assumptions - Don’t assume that your doctor knows everything about PD. They may specialize in say pulmonology but have only a basic understanding of PD.
- Nutrition – What you eat and when you eat may affect just how effective your medication will be. For example, too much protein can minimize the absorption of carbidopa/levodopa.
- Timing – Remembering to take your medications on time, every time! This will help manage your on time and off time.
Essentially, your doctor is tasked with the burden on how to maximize your medication with the least amount of side effects and zero contraindications and communicating that to you. Far too often I run across people living with PD that do not know this and have difficulty managing medications. The proper management of medication is of course following dosage instructions but as I’ve already stated, PD is a very complex disease that requires a variety of medications that may or may not work for you. This makes communication with your doctor extremely important. If it helps you, keep a list of medications that you take that should include the name of the medication, what you take it for and how often you take it. Also include any supplements that you may be taking. This will help your doctor make an informed decision about what medications to prescribe.
I would be remiss if I did not mention that exercise is a good form of medicine. In my opinion, a structured exercise program may actually stave off the need for prescription medication. Your local PD support organization can recommend a program that’s right for you. This doesn’t mean you don’t need prescription medication but a healthy program of good nutrition and regular exercise can limit the amount that you require.
Here’s the takeaway: Proper medication management is being honest with your doctor and communicating problems or changes, good and bad about what you are taking and following the recommended dosage as well as educating yourself on alternative therapies available to you. Remember to take your medications on a schedule (on time, every time). Set an alarm if necessary because part of the failure of good medication management is forgetting to take your medications on a timely basis.
Do you think there is enough awareness of Parkinson's disease?