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Current evidence indicates that symptoms of Parkinson’s disease are related to depletion of dopamine in the corpus striatumAdministration of dopamine is ineffective in the treatment of Parkinson’s disease apparently because it does not cross the blood-brain barrierHoweverlevodopathe metabolic precursor of dopaminedoes cross the blood-brain barrierand presumably is converted to dopamine in the brainThis is thought to be the mechanism whereby levodopa relieves symptoms of Parkinson’s disease.
Reports of patients taking dopaminergic medicationsmedications that increase central dopaminergic tonesuggest that patients may experience an intense urge to gambleincreased sexual urgesintense urges to spend moneybinge eatingand/or other intense urgesand the inability to control these urgesIn some casesalthough not allthese urges were reported to have stopped when the dose was reduced or the medication was discontinuedBecause patients may not recognize these behaviors as abnormalit is important for prescribers to specifically ask patients or the caregivers about the development of new or increased gambling urgessexual urgesuncontrolled spending or other urges while being treated with SINEMETPhysicians should consider dose reduction or stopping the medication if a patient develops such urges while taking SINEMETsee PATIENT INFORMATION
The early diagnosis of this condition is important for the appropriate management of these patientsConsidering NMS as a possible diagnosis and ruling out other acute illnessese.gpneumoniasystemic infectionetcis essentialThis may be especially complex if the clinical presentation includes both serious medical illness and untreated or inadequately treated extrapyramidal signs and symptomsEPSOther important considerations in the differential diagnosis include central anticholinergic toxicityheat strokedrug feverand primary central nervous systemCNSpathology.
Parkinson’s disease is a progressiveneurodegenerative disorder of the extrapyramidal nervous system affecting the mobility and control of the skeletal muscular systemIts characteristic features include resting tremorrigidityand bradykinetic movementsSymptomatic treatmentssuch as levodopa therapiesmay permit the patient better mobility.
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before initiating treatment with sinemet cr, advise patients about the potential to develop drowsiness and ask specifically about factors that may increase the risk for somnolence with sinemet cr such as the use of concomitant sedating medications and the presence of sleep disorders.
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