Progress and Prospects in Parkinson's Research/Symptoms

 This page is under development 

Site Map

This page includes links to pages describing the Symptoms of Parkinson's disease, their origin and treatments and the research being conducted relating to them.

( --- Introductory paragraph about Parkinson's symptoms etc --- )

There are many ways of classifying and listing symptoms and there are so many of them that a number of 'ways in' are listed in the expansion boxes below. (Click a box to toggle expansion of it.)

A - Z:

A to Z of Parkinson's Symptoms
Links to the symptoms of Parkinson's in alphabetical order: A B C D E F - G H I - L M - N O P - Q R S T U - Z (Click to go to table for editing)

By motor/non-motor classification:

Symptoms by clinical classification
Parkinson's symptoms are often classified regarding whether they are largely movement-related or not. Some symptoms appear to arise from use of certain drugs. Links to the symptoms of Parkinson's by a common clinical classification: Motor symptoms Non-motor symptoms Drug-induced symptoms

By neurological origin:

Parkinson's Symptoms by neurological origin
Links to the symptoms of Parkinson's by neurological origin: /Nigrostriatal degeneration|Nigrostriatal degeneration /Other_neurodegeneration|Other parts of the nervous system

By drugs that may cause them:

By drugs that may cause symptoms as side effects

The following side effects to common drugs used in the treatment of Parkinson's disease have been notified by pharmaceutical companies: Apokyn injection (apomorphine) Parkinson's Symptoms/Apokyn injection Aricept (denepezil) Parkinson's Symptoms/Aricept Artune (trihexyphenidyl) Parkinson's Symptoms/Artune Azilect (rasagilene) ( To subpage for editing >> ) AZILECT ® is prescribed as a supplement to levodopa for the treatment of Parkinson’s disease symptoms. Active ingredients Rasagiline Rasagiline is an irreversible inhibitor of monoamine oxidase used as a monotherapy in early Parkinson's disease or as an adjunct therapy in more advanced cases. It is selective for MAO type B over type A by a factor of fourteen. Inactive ingredients Mannitol Colloidal anhydrous silica Maize starch Stearic acid Talc Most common adverse reactions to AZILECT Very common (Affecting more tham 1 user im 10) Dyskinesia Headache Common (Affecting 1 to 10 users in 100} abdominal pain falls allergy fever flu (influenza) general feeling of being unwell (malaise) neeck pain chest pain (angina pectoris) orthostatic hypotension decreased appetite constipation dry mouth nausea and vomiting flatulence leucopenia(abnormal blood tests) arthralgia (joint pain) musculoskeletal pain joint inflammation (arthritis) carpal tunnel syndrome (weakness or numbness of the hands) decreased weight abnormal dreams postural instability depression dizziness dystonia (muscle contractions) rhinitis (runny nose) dermatitis (skin irritation) conjunctivitis (eye irritation) urinary urgency Less common adverse reactions to AZILECT {Affects 1 to 10 users in 1,000) stroke (cerebrovascular accident) heart attack (myocardial infarction) blistering rash (vesiculobullous rash) Drug interactions AZILECT should not be taken concurrently with:- monamine oxidase (MAO) inhibitors pethidine St. John's Wort Further Reading Search the scientific literature (Azilect) Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Azilect. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References Cogentin (benztropene) Parkinson's Symptoms/Cogentin Comtesse (entacapone) Parkinson's Symptoms/Comtesse Madopar ( To subpage for editing >> ) MADOPAR ® is widely prescribed for the treatment of Parkinson’s disease symptoms. Active ingredients Levodopa, an aromatic amino acid, is a white, crystalline compound, slightly soluble in water, with a molecular weight of 197.2. It is designated chemically as (—)-L-α-amino-β-(3,4-dihydroxybenzene) propanoic acid. Its empirical formula is C9H11NO4. Decarboxylase benzeraside Inactive ingredients Most common adverse reactions to MADOPAR Allergies (rash, itch,irregular heartbeat, blood in stools) Reduced white blood cells (infections of mouth, gums, lungs or throat) Reduced red blood cells (fatigue, bruise easily, prone to infections) Reduced platelets in blood (bruising, nose bleeds) Less common adverse reactions to MADOPAR Digestive system Loss of appetite Nausea Diarrhoea Heart and circulatory system Dizziness Blood Anaemia (Palpitations, Pale skin, Fatigue, Heart flutters, Shortness of breath). Mental Problems Excitement, Anxiety, Agitation, Agressin, Depression, Disorientation. Hallucinations, Out of touch with reality. Narcolepsy, Insomnia. Excessive urge to gamble. Excessive sex drive. Miscellaneous Dyskinesia. Loss of taste, Taste abnormalities. Redness of face or neck. Abnormal sweating. Drug interactions Further reading Search the scientific literature (Madopar) Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Madopar. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References Propranolol ( To subpage for editing >> ) PROPRANOLOL ® is occasionally prescribed for the treatment of Parkinson’s disease resting tremor. It is one of a group of drugs known as beta blockers. Active ingredients Propranolol hydrochloride Inactive ingredients Contents Lactose Manesium stearate Maize starch Stearic acid Hypromellose (E464) Coating Polysorbate Carmoisine (E122) Titanium dioxide {E171) Iron oxide - red {E172} Hypromelose {E464} Most common adverse reactions to PROPRANOLOL Less than 1 in 10 users Tiredness, fatique Cold extremities Sleep disturbance Slow or irregullar heartbeat Raynaud's syndrome Nightmares Less common adverse reactions to PROPRANOLOL Uncommon (Less than 1 in 100 users) Nausea, Vomiting Diarrhoea Rare (Less tha 1 in 1000 users) Blood cell changes (Nosebleeds, Bruising, Sore throats, Infections) Worsening of heart failure (Low blood pressure, Fainting on standing, Dizziness, Intermittent claudication) Dermatological problems (Skin rash,soriasis, Hair loss, Dry flaky skin, red/itchy skin) Neuroses (Hallucinations, Mood changes, Pinsand needles, Psychoses, Memory loss) Difficulty in breathing Dry eyes, Visual disturbances Not known (cannot be estimated from availble data) Hyperthyroidism Changes in blood fats Changes in kidney function Changes in blood sugar levels Fits (seizures) Worsening of Angina, Headache, Depression, Confusion Consti[ation Dy mouth Conjunctivitis Changes in sex drive or potency Joint pain Drug interactions Verapamil or Diltiazem to treat heart disease} Disopyramide or Quinidine or Amiodarone (to treat irregular heartbeat - arrhythmia) Ergotamine< derivates (to treat migraine} Adenaline {epinephrine used to treat anaphylactic shock) Insulin and other medicines for the treatment of diabetes. Lidocaine or Propafenine or Flecanide (used to treat irregular heartbeat or as a local anaesthetic} Indometacin (A Non-Steroidal Anti-inflammatory Drug- NSAID) Digitalis glycosdes (such as digoxin, use to treat heart disease} Chlorpromazine (for mental illness) Cimetidine (for stomach ulcers) Alpha blockersor Clonidine or Moxonidine or Methyldopa or Hydralaxine {for high blood pressure) Monamine oxidase inhibitors or Imipramine or <Fluvoxamine (for depression) Warfarin (to prevent clotting) Rizatriptan (for migraine) Rifampicin (to treat infection) arbiturates (to combat severe insomnia) Theophylline (for treating asthma and reversible airways obstruction) Diuretics (to clear excess water from the body) Further Reading References Requip ( To subpage for editing >> ) REQUIP ® is a dopmine agonist that widely prescribed for the treatment of Parkinson’s disease symptoms. Active ingredients Ropinirole hydrochloride Most common adverse reactions to REQUIP Nausea Vomiting Stomach ache Drowsiness Swelling of arms and legs Burning sensation in stomach if taken with alcohol Less common adverse reactions to REQUIP Lowered blood pressure {leading to Slow pulse; Falls; Orthostatic hyotension; Fainting; Unsteadiness; Dizzines} Somnolence (Extreme sleepiness) Sudden sleep episodes {Narcolepsy} Compulsive behaviour (e.g Sexual or gambling adiction} If taken with levodopa Dystonia (Jerky movements)) Hallucination Confusion Further Reading Position statement by the European Medicines Agency http://www.ema.europa.eu/docs/en_GB/document_library/Position_statement/2009/12/WC500017653.pdf References Sinemet ( To subpage for editing >> ) SINEMET® is widely prescribed for the treatment of Parkinson's disease and some Parkinson's_Plus syndromes. Active ingredients Carbidopa, is an inhibitor of aromatic amino acid decarboxylation, and is a white, crystalline compound, slightly soluble in water, with a molecular weight of 244.3. It is designated chemically as (—)-L-α-hydrazino-α-methyl-β-(3,4-dihydroxybenzene) propanoic acid monohydrate. Its empirical formula is C10H14N2O4•H2O. Levodopa, an aromatic amino acid, is a white, crystalline compound, slightly soluble in water, with a molecular weight of 197.2. It is designated chemically as (—)-L-α-amino-β-(3,4-dihydroxybenzene) propanoic acid. Its empirical formula is C9H11NO4. Inactive ingredients Hydroxypropyl cellulose Pregelatinized starch Crospovidone Microcrystalline cellulose Magnesium stearate SINEMET 10-100 and 25-250 Tablets also contain:- FD&C Blue #2/lndigo Carmine AL. SINEMET 25-100 Tablets also contain:- D&C Yellow #10 Lake. Most common adverse reactions to SINEMET Dyskinesia Nausea Less common adverse reactions to SINEMET Body as a Whole Chest pain, asthenia. Cardiovascular Cardiac irregularities, hypotension, orthostatic effects including orthostatic hypotension, hypertension, syncope, phlebitis, palpitation. Gastrointestinal Dark saliva, gastrointestinal bleeding, development of duodenal ulcer, anorexia, vomiting, diarrheoa, constipation, dyspepsia , dry mouth, taste alterations. Hematologic Agranulocytosis, hemolytic and non-hemolytic anemia, thrombocytopenia, leukopenia. Hypersensitivity Angioedema, urticaria, pruritus, Henoch-Schonlein purpura, bullous lesions (including pemphigus-like reactions). Musculoskeletal Back pain, shoulder pain, muscle cramps. Nervous System/Psychiatric Psychotic episodes including delusions, hallucinations, and paranoid ideation, neuroleptic malignant syndrome, bradykinetic episodes ("on-off" phenomenon), confusion, agitation, dizziness, somnolence, dream abnormalities including nightmares, insomnia, paresthesia, headache, depression with or without development of suicidal tendencies, dementia, pathological gambling, increased libido including hypersexuality, impulse control symptoms. Respiratory Dyspnea, upper respiratory infection. Skin Rash, increased sweating, alopecia, dark sweat. Urogenital Urinary tract infection, urinary frequency, dark urine. Drug interactions Symptomatic postural hypotension has occurred when SINEMET was added to the treatment of a patient receiving antihypertensive drugs. Severe orthostatic hypertenson can occur for patients receiving MAO inhibitors (Type A or B). There have been rare reports of adverse reactions, including hypertension and dyskinesia, resulting from the concomitant use of tricyclic antidepressants and SINEMET. Dopamine D2 receptor antagonists (e.g. phenothiazines, butyrophenones, risperidone) and isoniazid may reduce the therapeutic effects of levodopa. In addition, the beneficial effects of levodopa in Parkinson's disease have been reported to be reversed by phenytoin and papaverine. Iron salts may reduce the bioavailability of levodopa and carbidopa. Although metoclopramide may increase the bioavailability of levodopa by increasing gastric emptying, metoclopramide may also adversely affect disease control by its dopamine receptor antagonistic properties. Further Reading (1997) Block et al carried out a multi-centre trial over 5 years comparing the effects of Sinemet (immediate Release) and Sinemet CR (Controlled Release) and found favourably for the latter. Search the scientific literature (Sinemet) Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Sinemet. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar References Stalevo ( To subpage for editing >> ) STALEVO ® is widely prescribed for the treatment of Parkinson's disease and some Parkinson's_Plus syndromes. Active ingredients Carbidopa, is an inhibitor of aromatic amino acid decarboxylation, and is a white, crystalline compound, slightly soluble in water, with a molecular weight of 244.3. It is designated chemically as (—)-L-α-hydrazino-α-methyl-β-(3,4-dihydroxybenzene) propamic acid monohydrate. Its empirical formula is C10H14N2O4•H2O. Entacapone is somewhat similar to carbidopa or benserazide, in that it is an inhibitor of an enzyme that converts L-DOPA into a compound that cannot cross the blood brain barrier. Levodopa, an aromatic amino acid, is a white, crystalline compound, slightly soluble in water, with a molecular weight of 197.2. It is designated chemically as (—)-L-α-amino-β-(3,4-dihydroxybenzene) propanic acid. Its empirical formula is C9H11NO4 Inactive ingredients croselcarmellose sodium magnesium stearate maize starch] manitol (E421) povidone K30 (E1201) glycerol (422) hypromellose polysorbate 80 red iron oxide (E172) sucrose titanium dioxide (E171) yellow iron oxide (E172) Most common adverse reactions to STALEVO Dystonia (Uncontrolled movements) Nausea Paranoia and psychotic symptoms Depression (possibly with thoughts of suicide) Amnesia and cognitive deficits Less common adverse reactions to STALEVO Irregular heart rate and rhythm Light headedness or fainting due to low blood pressure Dizziness Drowsiness Sudden worsening of Parkinson's symptoms Loss of appetite Vomiting Bleeding in the gut Ulcers Abdominal pain Dry mouth Constipation Diarrhoea High blood pressure Inflammation of the veins in the legs Insomnia Hallucinations Confusion Unpleasant dreams Tiredness Muscle cramps Sweating Falls postural instability) Changes in blood cells Fainting Infections Bleeding Chest pain Shortness of breath Tingling or numbness Convulsions Rare or very rare effects Agitation Itching and rashes Weight loss or gain vision disturbances Muscle cramps Drug interactions Selective MAO-A plus MAO- inhibitors >non-selective MAO inhibitors (e.g. Moclobemide-aka Aurorix and Manerix.} noradrenaline re-uptake inhibitors (e.g. Desipramine- aka Desmethylimipramine; Maprotiline aka -Deprilept, Ludiomil, Psymion; Venlaxafine - aka Effexor or Efexor ) tricycline antidepressants (e.g. Amitryptiline - aka Tryptomer, Elavil, Tryptizol, Laroxyl, Saroten, Sarotex, Lentizol, Endep) Paroxetine aka Aropax, Paxil, Pexeva, Seroxat, Sereupin Isoprenaline aka Isoproterenol, Medihaler-Iso and Isupre Dopamine Dobutamine Alpha-methyldopa Apomorphine aka Apokyn, Ixense, Spontane, Uprima]] rimiterole Dopamine antagonists Phenytoin Papaverine iron supplements Adrenaline Further reading Search the scientific literature (Stalevo) Literature search: Use the following links to query the PubMed, PubMed Central and Google Scholar databases using the Search terms:- Parkinson's_Disease Stalevo. This will list the latest papers on this topic. You are invited to update this page to reflect such recent results, pointing out their significance. Pubmed (abstracts) Pubmed_Central (Full_Text) Google_Scholar (current) U.S. Food and Drugs Administration report on Stalevo, http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm206513.htm (2010) Podcast for Healthcare Professionals:Ongoing Safety Review of Stalevo (entacapone/carbidopa/levodopa) and possible development of Prostate Cancer http://www.fda.gov/Drugs/DrugSafety/DrugSafetyPodcasts/ucm207688.htm FDA Drug Safety Communication: Ongoing Safety Review of Stalevo and possible increased cardiovascular risk http://www.fda.gov/Drugs/DrugSafety/ucm223060.htm FDA Drug Safety Podcast for Healthcare Professionals: Ongoing Safety Review of Stalevo and possible increased cardiovascular risk http://www.fda.gov/Drugs/DrugSafety/DrugSafetyPodcasts/ucm223620.htm FDA Drug Safety Communication: Ongoing Safety Review of Stalevo (entacapone/carbidopa/levodopa) and possible development of Prostate Cancer http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm206363.htm Eurpean Medicines Agency report on stalevo. http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000511/human_med_001063.jsp&mid=WC0b01ac058001d124 References

Development of symptoms as the disease progresses:

Parkinson's Symptoms by stages

There are some common symptoms, some of which may be mild, that patients have at diagnosis and which may well have led them to consult their doctor in the first place. As time goes by further symptoms develop or become more obvious. /Common_Early|Symptoms of Parkinson's that patients are commonly aware of at diagnosis /Common_mid_stage|Common mid-stage symptoms of Parkinson's /Common_late_stage|Common late-stage symptoms of Parkinson's

This page and related subpages are still under development

This is the top page of a hierarchy of pages which, at the bottom level, will contain a set of sub pages each dealing with a single symptom of Parkinson's. The intermediate pages in the hierarchy will discuss each symptom group together according to the classification heading.

Related pages

The Science Behind Parkinson's portal

Progress and Prospects in Parkinson's Research

Introduction to Parkinson's Science