Phone
(800) 973-1540

Could Dad's Parkinson's medication adjustment be causing his seeming mental decline?

Gbooye asked...

My 81 year old father fell about four weeks ago and broke his femur. For the surgery they adjusted his Parkinson's medication to 25/100, five times a day. He use to be on 25/250, four times a day. He now seems to be in a mental decline.

I understand some of it is due to being in the hospital for four weeks and contracting pneumonia, but could some of it be due to the change in dosage of the medication? He is still receiving the 25/100 dosage.

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 very difficult situation that your father is facing, as Parkinson's patients very often decline for a while when hospitalized. I would expect that the long hospitalization with pneumonia contributed to his confusion. Although sinemet can cause confusion, hallucinations and other side effects when the dosage is increased, particularly in older PD patients with some underlying cognitive problems, I would think that this mild dose adjustment would not have made much difference. In order to asses this, we often return to the old dose for a few weeks to see if things clear up and then "re-challenge" with the newer dosing schedule. That being said, as your father clears from the hospitalization, I am hopeful that he will improve anyway.