There are a number of reasons why it might feel that Parkinson’s medications aren’t working. If this is an ongoing concern, then please contact your Parkinson’s team who may be able to make some suggestions to improve things. Here are some things to consider in the meantime.

Constipation

Constipation is very common in Parkinson’s.  It can result in slower transit and absorption of medication within the gut.  As a result, medications may not work as well. To find out more about constipation, follow this link to the My Parkinson’s page on bowel problems, and talk to your GP or Parkinson’s team if this is an ongoing problem.  It is important to eat a healthy, high-fibre diet to keep the gut working well.

Other medications

Some medications interfere with Parkinson’s medication and stop them working as well.  Some of the medications that are commonly seen to cause problems include:

• Some nasal decongestants and cold remedies can interfere with MAO-B inhibitors, so check with your pharmacist before using those.
• A commonly prescribed anti-sickness medication called metoclopramide reduces the action of dopamine in the brain, and can make the symptoms of Parkinson’s worse. It should be avoided in people with Parkinson’s.
• Prochlorperazine is a medication used to treat nausea and vertigo. It also blocks dopamine in the brain and should usually be avoided by people with Parkinson’s if possible.
• Some antipsychotic medications block dopamine in the brain and should be avoided in Parkinson’s. They include haloperidol, chlorpromazine and flupentixol. If you are worried about whether a medication is safe to take in Parkinson’s, check with the person prescribing it or with a pharmacist.

Medication timing

• It is important to take your medication at the same time every day so that the levels of levodopa in your brain stay topped up throughout the day.
• Some people find that medications vary slightly in their effect over the course of the day – if this is very noticeable it is important to discuss this as your Parkinson’s team may suggest changes to your medication.
• People with Parkinson’s often find that eating protein-rich food affects how well their medication works. Protein-rich foods such as meat, fish, dairy, eggs, beans and pulses can slow absorption of medication in the gut. Sometimes taking medication 30-60 minutes before a meal can help. Some people find it helps to have their main protein-containing meal in the evening, as it may not matter so much if medication is absorbed slowly then rather than earlier in the day. Protein is essential for the body to stay healthy, so do not cut it out from your diet, and do not dramatically change your diet unless you have discussed it with a dietitian, your GP or Parkinson’s team.
• If you think that changing the timing of your medication may be helpful, speak to your Parkinson’s team.
• If you forget a medication dose, don’t worry, just take your next dose as normal but do not take a double dose to “catch up”.

Progression of symptoms

• Unfortunately, Parkinson’s gets worse over time and it is normal for changes for the medication to be needed in order to control symptoms. When things get worse it may feel like the medication has stopped working. Don’t despair, there are usually many more things to try. Speak to your Parkinson’s team who will work in partnership with you to work out a plan.

Other conditions can affect Parkinson’s symptoms as well. It is especially important if there is a sudden change to discuss with your GP or Parkinson’s team as they may wish to rule out another cause, for example an infection.