What worsens Parkinson's disease?

The main symptoms of Parkinson's disease include stiffness, shaking (tremor), and slowness of movement. People with Parkinson's may also develop other symptoms, such as sleep disorders. Symptoms may be subtle at first and only noticed by close family members, but then typically become gradually worse over time and the disease affects every part of daily living.

Parkinson’s disease is usually a slowly progressive condition, but there are a number of things that can make your symptoms worse or to take effect more quickly in the long term.

What are the common things that can make Parkinson's disease worse?

Stress

As well as making the symptoms worse, stress can also make the problems associated with having Parkinson's disease worse - such as difficulties with memory and sleep problems.

Emotional factors

Emotions related to mood changes can make the symptoms of Parkinson's disease worse. Anxiety and depression are common emotional symptoms and illnesses that often develop and can have an impact on the symptoms of Parkinsons disease.

Medicines

A medicine called levodopa - usually prescribed as either co-beneldopa or co-careldopa - is often used for treating Parkinson's disease but may cause problems, such as a fluctuating responses to the treatment at some point. This problem is usually worse in people who take higher doses of levodopa. This problem with levodopa can often be improved by changing the dose to provide a more consistent level of the medicine throughout the day or to add on other treatments to take as well.

Some medicines can increase the risk of developing parkinson-like symptoms, even if you haven't had any symptoms of Parkinson's before - this is called drug-induced parkinsonism. The medicines with these possible side effects include:

• Antipsychotic medicines - in general, newer (second-generation) antipsychotics (such as amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, risperidone, sertindole, and zotepine) are less likely to cause parkinsonism than the older (first-generation) antipsychotics (such as fluphenazine, trifluorophenazine, haloperidol, chlorpromazine, flupentixol, and zuclopenthixol).

• Anti-sickness tablets - prochlorperazine. metoclopramide.

• Antidepressants - such as selective serotonin reuptake inhibitors (SSRIs).

• Calcium-channel blockers.

• Amiodarone.

• Lithium.

• Sodium valproate.

• Methyldopa.

• Pethidine.

Patient picks for Movement problems

Brain and nerves

What is vascular parkinsonism and what are the other types of parkinsonism

Parkinsonism is a general term that is used to describe a set of movement problems similar to those seen in Parkinson’s disease. There are a number of possible causes but the most common cause of parkinsonism is Parkinson's disease. Parkinsonism can cause severe problems with basic everyday activities.

by Dr Colin Tidy, MRCGP

Brain and nerves

Tourette syndrome

Tourette syndrome is a condition that causes you to make involuntary movements or noises called tics. It tends to be associated with various other problems such as behavioural problems and attention deficit hyperactivity disorder (ADHD). It can often be well managed with psychological treatments and sometimes with medication. Simple motor tics are brief and sudden repetitive movements that involve just a few muscle groups. Simple vocal tics involve saying a word or phrase, or making a different noise. Complex tics involve several different muscle groups in areas throughout your body. Complex motor tics include jumping, bending, twisting or other complex movements. Complex vocal tics include repeating other people’s words or phrases (echolalia), or using obscene, vulgar or swear words (coprolalia). The most common of all childhood tics is Tourette syndrome.

by Dr Colin Tidy, MRCGP

Health changes

Changes in your overall health can also affect the symptoms of Parkinson's disease. An increase or worsening of Parkinson's disease symptoms can sometimes be linked to infections, surgery, medication changes, or developing other diseases or conditions.

Foods

It has been suggested that some foods may speed up the progression of Parkinson's disease symptoms. There is no strong evidence for any particular food and it may be that each person with Parkinson's disease is affected by different foods, or not affected by any foods at all.

It has been suggested that the foods that may aggravate Parkinson's symptoms include those high in saturated animal fats - such as fried foods, red meat, ice cream and cheese. It has also been suggested that a Mediterranean diet may be a good option for people with Parkinson's disease.