Is Mom experiencing Parkinson's symptoms or side effects from Sinamet?

A fellow caregiver asked...

My mother has mild Parkinson's. She was diagnosed two years ago at age 78. She is so tired all the time, and feels like she is pushing her legs to move which wears her out. She also feels wobbly and seasick all the time. Is this the Parkinson's or the medication? She takes Sinamet, 4.5 pills a day at 25/100mg each. Thank you for the great service your website provides!

Expert Answer

Graham A. Glass, MD, is the co-founder of PEAK Neurology and Sleep Medicine, LLC with multiple locations across Alaska. Previously, he was deputy director of the San Francisco Parkinson's Disease Research, Education, and Clinical Care Center PADRECC and assistant clinical professor of neurology at the University of California, San Francisco (UCSF). Glass received his medical degree from the University of Texas Health Sciences Center at the San Antonio School of Medicine and completed his neurology residency at Tufts-New England Medical Center. He subsequently completed a fellowship in movement disorders at the Mayo Clinic.

This is a tricky question, as Parkinson's can cause fatigue, balance difficulty and an overall sense of weakness. That being said, sinemet can cause or worsen tiredness (15% of patients). Typically when we encounter this dilema we will make a bold move of either increasing or decreasing the sinemet to get more infomation. If increased medication doses help, then we know that the Parkinson's disease is to blame, however if increased doses make the symptoms worse, then we suspect that sinemet is to blame and can think about other options.