Parkinson's Disease Community

hello, cathy --

i fervently hope that dr. stacy will answer your post also, because i am not a medical person (see PS1), plus his knowledge and experience will override anything I say.

before i get into any factual information, may i ask why you have decided to stop taking all of your meds except those for your heart? this could be very dangerous. does your dr know you are contemplating this?

do i understand from your post that you believe some of your meds might have caused your parkinson's? assuming that to be your concern, i did some internet research yesterday to see what i could find out about the half-lives (PS2, PS3) of your meds and the possibility that any of them could cause parkinson's or parkinson's-like symptoms. i'll go thru them one by one, starting with your heart meds.


atenolol/tenormin treats high blood pressure, irregular heartbeat, and heart failure. webMD info on this med is at http://www.webmd.com/drugs/drug-11035-atenolol Oral.aspx?drugid=11035&drugname=atenolol Oral&source=2 . i did not find anything indicating that parkinson's or parkinson's-like symptoms were a side effect of this med.

the half-life for atenolol/tenormin is cited variously (PS4) as 6-9 hrs and 16-27 hrs, altho it stays effective for 24 hrs after being discontinued. this means that if its half-life is 6-9 hrs, it will take five of those intervals, or 30-45 hrs (between one and one-fourth days, and almost two days), to get to the point where only 3% of the original amt remains in your body. if its half-life is 16-27 hrs, it will take 80-135 hrs (between three and one-third days, and a little more than five and one-half days) to get to the 3% amt.

in other words, depending on which range for half-life is closer to being accurate, it could take between one and one-fourth days, and a little more than five and one-half days, for your body to clear atenolol/tenormin to a 3% level.

i know you intend to keep taking this med, but if you should decide to discontinue it someday, do not stop abruptly. altho your body may be almost empty of this med after five half-life intervals, it might take longer than that for your body chemistry to adjust to not having a certain amt of this med in your bloodstream. this means that rather than just stopping all at once, you may want to reduce your 50-mg dosage to 40 mg for a week, then to 30 mg for a second week, to 20 mg for a third week, etc. stopping completely before your body has that chance to adjust invites withdrawal symptoms, which can be quite unpleasant.


the computer tells me that i am close to reaching the word limit for this post, so can you meet me at my subsequent one?

-- susie margaret

PS1 -- i welcome, solicit, and indeed beg for correction, amendment, or replacement of inaccuracies in this post.

PS2 -- the half-life of a med is the amt of time it takes for half of it to clear your body. in other words, if the half-life of a particular drug is 10 hours, that means that after 10 hrs, half of the med will have cleared your body, leaving the other half still absorbed. after another 10 hrs, half of what was left (in other words, half of half, or one-fourth of the original amt) will also have cleared your body, leaving one-fourth of the original amt. after a third 10 hrs, half of that amt (half of one-fourth of the original amt, or one-eighth of the original amt) will have cleared.

PS3 -- with these reductions, it takes about five half-life cycles to clear your body of a med to the point where only 3% is left. still using the example of a 10-hr half-life, it would therefore take five 10-hr periods, or 50 hrs (a little more than two days), to get to the point where only 1/32 (or 3%) of the original amt remained in your body.

PS4 -- different studies of the same med come up with different half-lives, for reasons i don't really understand.

hello again, cathy --

this is the second part of my response to your inquiry about whether any of your meds could have caused your parkinson's.


flecainide/tambocor treats irregular heartbeat. webMD info on it is at http://www.webmd.com/drugs/drug-6109-flecainide oral.aspx . "involuntary quivering" is listed as an "infrequent" side effect. did you experience this before you added your other meds?

the half-life for this med is given as 11-27 hrs, meaning that it will take 55-135 hrs to clear your body to 3% remaining (PS5). in other words, it could take between a little less than two and one-third days, and a little more than five and one-half days, for your body to clear flecainide/tambocor to a 3% level.


atorvastatin/lipitor is used to reduce high cholesterol, thereby preventing heart attack or stroke. webMD info on it is at http://www.webmd.com/drugs/drug-841-atorvastatin oral.aspx .

its half-life is 14 hrs, which means that it could take 70 hrs (almost three days) to clear your body to a 3% amt. immediately after stopping this med, however, its effectiveness lasts for 20-30 hrs.


carbidopa-levodopa/sinemet is used to treat parkinson's and parkinson's-like symptoms; it is also prescribed for extreme discomfort in the calves when sitting or lying down. webMD info on this med is at http://www.webmd.com/drugs/mono-41-CARBIDOPA%2fLEVODOPA - ORAL.aspx?drugid=3394&drugname=carbidopa-levodopa Oral&source=2 .

curiously, loss of coordination is listed as a "common" side effect, "twitching" as an "infrequent" one. in fact, dyskinesias (involuntary movements) in general, or a worsening of dyskinesias already being suffered (characterized as "unlikely but serious" and about which you should tell your dr "immediately," according to the relevant materials), can be a side effect of this med. if this happens, a reduction in dosage should be considered. finally, heart patients need especially close monitoring when beginning to take this med, because it can make some heart problems worse.

the half-life of levodopa, the part of this med that affects the chemicals in the brain (PS6), is 90 mins. it would therefore take 450 mins (seven and one-half hrs) to clear the body to a 3% level.

if you should decide to discontinue carbidopa-levodopa/sinemet, do not stop abruptly. as with atenolol/tenormin, altho your body may be almost empty of this med after five half-life intervals, it might take longer than that for your body chemistry to adjust to not having a certain amt of this med in your bloodstream. this means that rather than just stopping all at once, you may want to reduce your 25/100-mg (PS7) dosage (one pill, i am presuming) to about two-thirds of a pill for a week, then go to the pill with the next lowest dosage for a second week, to half of one of those pills for a third week, etc. stopping completely before your body has that chance to adjust invites withdrawal symptoms, which can be quite unpleasant.


i see that i am about to reach the word limit again, so can you meet me at my next post?

-- susie margaret

PS5 -- however, one report on flecainide/tambocor that i found stated that the half-life was 20 hrs for a single dose but that for multiple doses the half-life could be three to five days. i don't know what to make of those statements, because altho i looked at several drug info websites, i didn't see anything resembling those statements repeated anywhere else.

PS6 -- carbidopa acts to prevent the breakdown of levodopa in the bloodstream; this enables more levodopa to reach the brain.

PS7 -- a 25/100-mg dosage of carbidopa-levodopa/sinemet means that it contains 25 mg of carbidopa and 100 mg of levodopa.

hello again, again, cathy --

this is the third part of my response to your inquiry about whether any of your meds could have caused your parkinson's.


levothyroxine/levothroid, levoxyl, synthroid, unithroid is used to treat an underactive thyroid (hypothyroidism) and other thyroid disorders. webMD info on this med is at http://www.webmd.com/drugs/drug-1433-levothyroxine Oral.aspx?drugid=1433&drugname=levothyroxine Oral&source=2 . "involuntary quivering" is a "rare" side effect.

with this med, especially for people with heart problems, it is necessary to be careful that the body's thyroid level does not inadvertently get too high. the informational materials on this med state that you should tell your dr "immediately" if you experience signs of having too much thyroid; one of those signs -- which is characterized as "unlikely but serious" -- is shaking/tremor.

the half-life of this form of synthetic thyroid (known as T4) is 7-10 days, meaning that it could take 35-50 days (between five and seven weeks) to clear your body to a 3% level.


montelukast/singulair is for the treatment of allergies and asthma. webMD info on it is at http://www.webmd.com/drugs/mono-8277-MONTELUKAST - ORAL.aspx?drugid=6478&drugname=montelukast Oral&source=2 . "involuntary quivering" is a "rare" side effect.

the half-life of this med is 162-330 mins, meaning that it would take 810-1,650 mins (between thirteen and one half hrs, and twenty-seven and one-half hrs) to clear the body to a 3% level.


pantoprazole/protonix is used to treat excess acid and its effects in the stomach and esophagus; it also treats gastrointestinal ulcers. webMD info on it is at http://www.webmd.com/drugs/drug-17633-pantoprazole Oral.aspx?drugid=17633&drugname=pantoprazole Oral&source=2 .

a "serious" side effect of pantoprazole/protonix is "persistent muscle spasms," about which you should tell your dr "right away," according to the informational materials, if they occur. "involuntary quivering" is a "rare" side effect.

the half-life of this med is 66 mins, which means that it would take 330 mins (five and one-half hrs) to clear the body to a 3% level.


i am almost thru but want to add just a few comments more. i appreciate your patience! can you meet me at my next -- and final, i promise -- post for those?

-- susie margaret

hello, hello again, again, cathy --

this is the fourth and final part of my response to your inquiry about whether any of your meds might have caused your parkinson's. I can assure you that this post will be short compared to the others!

i want to caution you that altho i obtained all of the half-life info from what i consider absolutely trustworthy websites, numbers are not my strong suit, so the various calculations i've made as a consequence about the times for clearance of each med -- while i am fairly sure are accurate -- are still subject to arithmetic and algebraic errors! if anyone sees a mistake in these figures, please point it out, and i will happily correct it.

cathy, i hope this gives you helpful data for making a decision about quitting all but your heart meds. however, i want to emphasize my opinion that stopping all of these meds at once is a bad idea. for one thing, it will not tell you which, if any, particular ones might be responsible -- if indeed any are -- for your parkinson's; you would be able to figure that out only by continuing to take all of them and dropping one at a time or by quitting all of them at once and then adding one at a time back in. i believe that doing either without a dr's supervision is very risky.

one suggestion i will make is that you call the movement disorders specialist's office and ask to be put on the "cancellation list"; that way, if someone has to cancel an apptmt scheduled for a date before yours, you can take the slot that becomes empty.

let me say one more thing, then i'll get off my soapbox. i know how scary it is to contemplate having parkinson's; i know this because i have it myself. i go thru periods where i am practically paralyzed with fear of the future. but altho this horrible disease cannot yet be cured, it can be treated effectively for years. indeed, its eventual effects are not even predictable for each person. please keep taking all of your meds at least until you can see the movement disorders specialist.

i send you many caring thoughts and hope you will keep us posted on how you are doing.

-- susie margaret

Dear cathyparr,
I am sorry for my delay. The medications you list are not proven to be associated with the development of parkinsonism. Rarely agents similar to lipitor have been linked to parkinsonism, but patients also reported limb pain and mild difficulty with memory.

Now my advice: Do not ever stop a doctor prescribed medication without a doctor's knowledge. If you have already stopped the drug "cold turkey" you may notice rapid pulse, flushing or an elevated temperature. If this is a case, call your doctor. If you are going to stop the parkinson med no matter what ... decrease it to one a day for one week before stopping.

- Susie Thank you for the info no the Dr didn't know I stopped my med but after a week of being off of them the tremors came back so bad I had to get back on my meds I know now my reg meds have not caused my Parkinson.DJ at the Pharmacy has known me and my meds for years now he also ran all my meds and found that the only pill that enter acts with in my Levothyroxine is a very minor inter action is with my insulin not enough to worry about all it dose iscause my sugar to drop a little,and i check that 3 times a day.any how back on all my meds now.
You have a great day
Cathy

Thank you Dr Stacy for getting back to me,I am back on all my medications now I was off everything but my heart meds and the

tremors came back so bad I couldn't stand it but I know now my meds aren't causing the tremors.I have an appointment with a
specialist in January after I get the MRI done on my head.My heart Dr told me Dr .Hauser is one of the best at
scripps In San Diego.and yes I did catch the devil from him for what I did.thank you again for getting back to me