Levodopa is a drug that’s converted into the neurotransmitter dopamine once it reaches the brain. Doctors prescribe this drug because PD patients usually have decreased levels of dopamine, an important chemical messenger for the brain cells.
Using this drug, however, could result in shifting dopamine levels. You see, when the medication wears off, the dopamine levels drop. When you take levodopa again, the levels will rise.
The continuous shifting in dopamine levels results in dyskinesia or involuntary movements. This complication manifests as twitching, fidgeting, or head-shaking.
Management
Managing dyskinesia in advanced Parkinson’s disease requires cautious and individualized anti-PD therapy.
The doctors might lower the dose of L-dopa or resort to extended-release formula medication.
Bowel and Urinary Complications
Bowel problems, such as constipation are evident even in the early stage of Parkinson’s.
However, it becomes more severe in advanced-stage PD because of the cumulative effects of dehydration, decreased motility, immobility, and effects of anti-PD drugs.
In terms of urinary complications, a patient with Parkinson’s could experience frequency or urgency as well as urinary incontinence.
All these could lead to feelings of stress, anxiety, and isolation.
Management
For bowel and bladder problems, doctors often prescribe medications. But, constipation could be further managed by increased fluid intake and dietary fiber supplements that help improve intestinal motility.
Orthostatic Hypotension
Orthostatic hypotension or postural hypotension is one of the Parkinson’s disease late-stage complications. In this condition, a patient experiences low blood pressure within minutes of standing up from a sitting or lying position.
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