Hospital stays for people with PD require special consideration, especially when it comes to medication. Before your hospital visit, make sure you have a complete, updated list of your medications, dosages, and the times of day that you take them. Keeping an accurate, up-to-date list decreases the likelihood of an unwanted medication interaction. Studies have found that one in three people with PD have been prescribed contraindicated drugs while they were hospitalized, which highlights the importance of always having an up-to-date list of medications available.
Be sure your hospital care team understands that all Parkinson's medications must be given on time. You and your care partner should strongly advocate on your behalf for this important point.
In addition to your list of medications, bring with you a list of your current symptoms. This will help your hospital care team recognize these symptoms, as they may not be familiar with such problems as dyskinesia, ON-OFF fluctuations, and freezing of gait. Be sure to let them know how your movement and abilities change during ON and OFF times. This also helps the hospital care team understand why it is so important for you to get your medications on time, every time.
Some medications can worsen motor symptoms of Parkinson's. These drugs, listed below, are often used to treat psychiatric problems such as hallucinations, confusion, or gastrointestinal problems such as nausea. It's important that your hospital team is aware that many common anti-hallucination medications must be avoided in people with Parkinson's, since they might otherwise prescribe these medications if, as is common, the stress of your illness, hospital stay, or new medications cause hallucinations or delirium while you are hospitalized. New onset delusions, paranoia, and agitation signal to the medical team that a longer hospital stay or skilled nursing is required before going home.
Anti-hallucination Medications to Avoid
The anti-hallucination medications quetiapine (Seroquel), clozapine (Clozaril), and pimavanserin (Nuplazid) can be used with Parkinson's. Of these, Nuplazid is the only anti-hallucination medication approved for Parkinson's. The following should be avoided:
Perphenazine and amitriptiline (Triavil)
Anti-Nausea Medications to Avoid
Serotonin (5-HT3) antagonists work to block the effects of serotonin to reduce nausea and vomiting and do not worsen symptoms of Parkinson's. Ondansetron (Zofran), dolostone (Anzemet), and granisetron (Granisol) are acceptable alternatives to the list below. Older and cheaper anti-nausea medications block dopamine, therefore worsening Parkinson's symptoms. The following should be avoided:
Medications to Avoid if you take Rasagiline (Azilect) or Selegiline (Eldepryl)
Pain medications meperidine (Demerol), tramadol (Ultram), and methadone
Antispasmodic medication (Flexeril)
Dextromethorphan (cold medication) and ciprofloxacin (antibiotic)
Disclaimer: The information provided on this Parkinson Association of Alabama Resource Center is for awareness and educational purposes only about Parkinson's medication. The PAA does not endorse any specific brand or type of medication. All discussions about medication should be between you, your care partner, and your medical teams.
Davis Phinney Foundation. Parkinson's Treatments and Therapies. Chapter 7 - Medication. Pages 131. Every Victory Counts. "Manual" Sixth Edition, 2021.