“ASK THE DOCTOR” WITH DR. REBECCA GILBERT
Q: My mother was just prescribed carbidopa/levodopa and she has been incredibly sleepy since she started it. Could this be because of the medication?
A: Carbidopa/levodopa can definitely cause fatigue, and your mother may be experiencing this side effect from the medication. When this happens, and the side effect of the medication causes more trouble than the positive benefits of the medication, then it makes sense to consider making a change. One strategy that may help is switching to a longer-acting carbidopa/levodopa, such as Sinemet® CR, Rytary®, or Crexont®. It is possible that fatigue from the medication will not be as profound with one of the other formulations of carbidopa/levodopa.
Q: My partner was diagnosed with PD four years ago. Her main issue is bloating and belly pain, which negatively affects her quality of life in a very profound way. What can we do to improve this?
A: These symptoms could be due to a non-motor symptom of PD called gastroparesis or slowed transit through the stomach/upper gut. Here are some lifestyle modifications that may help: eating small frequent meals, avoiding fatty foods, and walking/moving after eating. In some cases, a medication called prucalopride (Motegrity) can be tried to enhance the motility of the upper gut. Constipation must also be treated because when the lower gut doesn’t move well, the upper gut doesn’t move well either.
Dr. Rebecca Gilbert is the Chief Mission Officer at APDA. She oversees APDA’s research portfolio in conjunction with APDA’s Scientific Advisory Board. She also provides medical and clinical expertise to support APDA programming as well as print and web content.