Parkinson’s Choices: Playing an Active Role In Your Treatment Plan

Registration is now open for the next installment in the APDA Spotlight series, Parkinson’s Choices: Playing an Active Role In Your Treatment Plan. 

This event is scheduled for Wednesday, August 17 from 12:00 – 1:00 Central Time and will be accessible online and via conference call. The presenters will be Dr. Jaime Hatcher-Martin of Emory University School of Medicine and Dr. Harrison Walker of the University of Alabama at Birmingham. Registration is free and open to the public. Please review the form below for registration instructions and additional information.

Download the PDF file .

Discovery may lead to a treatment to slow Parkinson’s disease

Scientists have shown that the most common genetic cause of Parkinson’s disease — a mutant LRRK2 kinase enzyme — contributes to the formation of inclusions in neurons, resembling one of the hallmark pathologies seen in Parkinson’s disease. These inclusions are made up of aggregated alpha synuclein protein, which — the research also shows — can be prevented from forming by using two LRRK2 kinase inhibitor drugs now being developed for clinical use. Click the link below to read the full article…

Source: Science Daily

MJFF Podcast: Treating Parkinson’s Hallucinations and Delusions

By Michael J. Fox Foundation

This week’s MJFF Podcast features Dr. Rachel Dolhun and explores Parkinson’s disease psychosis, including hallucinations and delusions, and discusses treatments for this symptom.

Parkinson’s disease psychosis can affect up to 40 to 50 percent of people with the disease. It can include hallucinations (seeing things that aren’t there) and delusions (fixed, false beliefs).

To treat this symptom, doctors have used traditional anti-psychotic drugs, but those have presented challenges.

“The problem with [traditional anti-psychotic] medications is that they block the dopamine receptors or they decrease the dopamine, and as people with Parkinson’s disease know pretty well, dopamine is what’s lost in Parkinson’s,” says Rachel Dolhun, MD, vice president of medical communications at MJFF. “So if we’re blocking the dopamine that we’re trying to already replace with our [Parkinson’s] medications, we can potentially worsen the motor symptoms of Parkinson’s disease.”

Earlier this month, the Food and Drug Administration (FDA) approved a drug, called Nuplazid, which was specifically designed to treat Parkinson’s psychosis without interfering with a patient’s dopamine medications.

Hear more from Dr. Dolhun about PD psychosis and Nuplazid through the Third Thursday Webinar from The Michael J Fox Foundation on May 19, 2016 at 12 p.m. ET/9 a.m. PT. Register now.

Source:: MJFF Podcasts

FDA Approves Parkinson’s Psychosis Drug

By Maggie McGuire Kuhl

The Food and Drug Administration has approved Nuplazid (the compound pimavanserin) from pharmaceutical company Acadia to treat Parkinson’s psychosis.

Psychosis — which may eventually affect more than half of people with Parkinson’s disease — can appear in a variety of ways, including hallucinations (seeing things that aren’t there) and delusions (holding false, typically paranoid, beliefs).

Read more on Parkinson’s psychosis in the MJFF “Ask the MD” blog.

“Nuplazid represents a major medical advancement for patients with Parkinson’s disease psychosis who suffer from hallucinations and delusions,” said Steve Davis, Acadia’s president and CEO. “We are grateful to the many patients and investigators who participated in Nuplazid’s clinical studies.”

Previously available psychosis medications worked on both the dopamine and serotonin systems. Parkinson’s medications for motor symptoms also work on the dopamine system, and taking antipsychotics blocked the effect of those drugs. So doctors and patients had to make a trade-off to treat either psychosis or motor symptoms.

Nuplazid, the first medication approved specifically for Parkinson’s psychosis, works only on the serotonin system. Clinical trials showed the drug eased psychosis symptoms without worsening motor symptoms.

“Parkinson’s disease psychosis is a debilitating condition that adds a tremendous burden on the lives of patients already contending with motor issues such as slow movement, loss of balance, and muscle rigidity,” said Todd Sherer, PhD, MJFF CEO. “It also places an increased burden on caregivers and can lead to loss of independence and nursing home admittance for patients. A therapy to treat the hallucinations and delusions associated with Parkinson’s disease psychosis without worsening motor symptoms can significantly impact the lives of Parkinson’s patients and their loved ones.”

MJFF did not fund the development of Nuplazid, though the Foundation has granted Acadia for studies into a disease-modifying therapy.

Acadia is committed to helping people with Parkinson’s access this new drug. Talk to your doctor about this therapy and visit www.nuplazid.com or call 844-737-2223 for more information.

Join the Michael J Fox Foundation on May 19 for a webinar on Parkinson’s psychosis and Nuplazid.

Source:: Fox Feed Blog

Ask the MD: Parkinson’s Disease Psychosis

By Rachel Dolhun, MD

Parkinson’s disease (PD) psychosis has been in the news as pimavanserin (Nuplazid) — a novel medication to treat this non-motor symptom — nears possible Food and Drug Administration approval. (A final decision will be made no later than May 1, 2016.) Pimavanserin would be the first drug indicated for PD psychosis and could be an important step in the evolution of therapies for non-motor symptoms of Parkinson’s.

PD Psychosis Comes in Varied Forms
Estimates vary — maybe because symptoms are underreported — but psychosis can eventually affect more than half of people with PD. This symptom is more common in people with a longer duration (and increased severity) of disease, cognitive impairment or dementia, and older age. Other risk factors include mood, sleep and visual (e.g., need for corrective lenses, cataracts, glaucoma) disturbances. Psychosis can appear in a variety of ways, including:

  • Hallucinations: seeing things that aren’t there
  • Delusions: holding false, typically paranoid, beliefs
  • Illusions: misinterpreting things that are there
  • False sense of presence: feeling that someone is nearby when no one is present

Hallucinations and delusions occur most often in those with Parkinson’s. Visual hallucinations usually consist of people (e.g., small children or deceased relatives) or animals; they happen in the evening (or periods of lower stimulation) and last seconds to minutes. Delusions typically center on themes of spousal infidelity or financial concerns and — despite evidence pointing otherwise — a person cannot be convinced of their falsehood. An illusion is mistaking one object for another (i.e., thinking a garden hose is a snake).

In some cases, psychosis is mild and a person knows that these experiences are not real. In others, symptoms are more severe and can considerably disrupt the lives of the person with PD, his or her caregiver, and family. PD psychosis may even contribute to the need for an alternative living situation, such as a nursing home.

Parkinson’s Disease and Drugs Can Cause Psychosis
Parkinson’s psychosis can be caused by the underlying disease and/or the medications used to treat it. As the brain chemical dopamine diminishes in Parkinson’s, many PD drugs work to temporarily replenish it. While the increased dopamine can lessen motor symptoms, it can also stimulate brain areas that lead to psychosis.

Management of Psychosis Requires a Stepwise Approach
When psychosis occurs, doctors first look for other medical illnesses — such as infections or electrolyte imbalances — that could be causing symptoms. If these aren’t present or psychosis persists after treatment, the next step is to reduce and/or remove Parkinson’s drugs. The goal of medication adjustment is to decrease psychosis without significantly worsening motor symptoms. If this cannot be done, an atypical antipsychotic agent may be added. These drugs are used for mood and thought disorders, such as schizophrenia, but they are prescribed off-label for PD psychosis. They generally work by blocking dopamine effects, though, so as they ease psychosis, they may make motor symptoms worse. Clozapine (Clozaril) is the least likely to do the latter, but low doses of quetiapine (Seroquel) are well tolerated too, so doctors typically prescribe one of these medications. Potential risks with these medications include sleepiness and, for clozapine, a decrease of infection-fighting white blood cells (which necessitates regular blood monitoring). In some situations, rivastigmine (Exelon) — which is indicated for PD dementia — is prescribed off-label for psychosis instead.

Pimavanserin Represents a Potential New Therapy for Psychosis
The approval of pimavanserin would potentially expand the somewhat limited treatment options for psychosis in Parkinson’s. Pimavanserin works on the serotonin (rather than dopamine) brain chemical system. Since this is a different mechanism than that of the presently available antipsychotic medications, it might help psychosis without aggravating motor symptoms. In short-term studies, the medication also seemed to improve nighttime sleep and daytime wakefulness while lessening the burden of psychosis on caregivers.

If pimavanserin is approved, it’s important to remember that (like every medication) it can have side effects and it isn’t right for everyone. A person who is doing well on his or her current drug regimen doesn’t necessarily have to change simply because a newer therapy comes on the market. But, for those with uncontrolled psychosis and/or intolerable side effects on current treatment, trying a different drug may be beneficial. No matter which therapy is chosen, communication about medication benefits and side effects, as well as regular assessment of the challenges psychosis poses for both the person with PD and the caregiver, must be maintained. Optimal management of each Parkinson’s symptom always requires input from every person on the care team: patient, caregiver, family members and physician.

about pimavanserin.

 

The “Ask the MD” series is supported by Acorda Therapeutics. While our generous sponsors make the “Ask the MD” program possible, their support does not influence MJFF’s content or perspective.

Source:: Fox Feed Blog

5 Tips For Educating Your Patients On Parkinson’s Disease

By Megan Ray

As a health professional it’s important to educate your patients on prevalent diseases to ensure that they’re doing everything they can to avoid them. It’s also essential that they know how to support loved ones if they’re diagnosed with one of these common illnesses. For example, during Parkinson’s Awareness Month in April, it’s essential to familiarize patients with the progressive movement disorder and how it impacts people across the U.S. Here are a few tips for helping your patients understand Parkinson’s.

1. Provide details on how the disease develops.
Most people have heard of Parkinson’s disease, a condition that affects as many as 1 million Americans, according to the Parkinson’s Disease Foundation. However, you may find that if you asked your patients what exactly Parkinson’s is, they wouldn’t know how to answer. This is why explaining how the disease develops is a good starting point when educating people on the condition. Note that Parkinson’s occurs when the vital nerve cells in the brain called neurons start to malfunction and eventually die. These neurons are fundamental to people’s health because they produce dopamine, a chemical that sends messages to the brain that coordinate movement and muscle coordination. Individuals who have a very low level of dopamine begin to experience difficulty controlling their movements and are often diagnosed with Parkinson’s.

2. Explain the treatment options for the condition.
Point out to your patients that one of the reasons Parkinson’s is such as serious disease is that there isn’t currently a cure for the condition. A significant amount of research has been performed over the past several years to uncover possible causes. As a result, many effective treatment and therapy options are available for Parkinson’s patients to alleviate the symptoms of the disease. Potential causes that have been studied include environmental and genetic factors.

3. Educate them on the symptoms.
While every patient has a different experience with Parkinson’s in regard to how quickly it progresses and the side effects they notice, there are four main symptoms that most people will develop. These include tremors in the hands, legs, jaw and arms, muscle stiffness or rigidity, bradykinesia – or slowness of movement – and posture instability. Other common side effects include fatigue, constipation, sleep disturbances, depression, anxiety and a decline in cognitive function, according to the Parkinson’s Disease Foundation.

4. Emphasize the importance of screenings.
While an estimated 1 million people in the U.S. may be living with Parkinson’s disease, only about 60,000 have been diagnosed, as it’s not uncommon for cases to go undetected. Don’t forget to point out that only four percent of those diagnosed with the disease are under the age of 50, as people’s risk of Parkinson’s increases with age. Statistics also show that men are slightly more vulnerable to the disease. Encourage patients to see their doctor if they experience any of the symptoms of the condition, such as tremors. The sooner that they can begin receiving therapy or treatment for their symptoms, the less of an impact Parkinson’s will have on their daily lives.

5. Provide them with resources for support.
Whether your patients have recently been diagnosed with the disease, are caring for a loved one who has been diagnosed or know someone with the condition, they’ll probably want to know who to reach out to for help. For example, caregivers may want information on local support groups and guides to understanding the common symptoms of the disorder. Handing out your own pamphlets is a great way to give patients direct access to key facts and resources. However, directing them to the resources provided by the National Parkinson’s Foundation and the organization’s helpline at 1.800.4PD.INFO or helpline@parkinson.org is also an effective way to ensure they have the assistance they need when required.

Source:: The Sunrise Blog

Experimental Parkinson’s Treatment uses MRI Guided Ultrasound

Interesting news out of the University of Maryland Medical Center  and the University of Maryland Medical School on an experimental treatment for Parkinson’s disease that utilizes MRI Guided Ultrasound and shows promising early results. Click this link to read more about this experimental treatment.

Click this link to read more about this experimental treatment.