Hospitalization and Medication Preparedness

Some medications can worsen motor symptoms of Parkinson's. These drugs, listed below, are often used to treat psychiatric problems such as hallucinations, confusion, or gastrointestinal problems such as nausea. It's important that your hospital team is aware that many common anti-hallucination medications must be avoided in people with Parkinson's, since they might otherwise prescribe these medications if, as is common, the stress of your illness, hospital stay, or new medications cause hallucinations or delirium while you are hospitalized. New onset delusions, paranoia, and agitation signal to the medical team that a longer hospital stay or skilled nursing is required before going home.

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Anti-hallucination Medications to Avoid

The anti-hallucination medications quetiapine (Seroquel), clozapine (Clozaril), and pimavanserin (Nuplazid) can be used with Parkinson's. Of these, Nuplazid is the only anti-hallucination medication approved for Parkinson's.  The following should be avoided:

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• Aripiprazole (Abilify)

• Chlorpromazine (Thorazine)

• Fluphenazine (Prolixin)

• Haloperidol (Haldol)

• Molindone (Moban)

• Perphenazine (Trilafon)

• Perphenazine and amitriptiline (Triavil)

• Risperidone (Risperdal)

• Thioridazine (Mellaril)

• Thiohixene (Navane)

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Anti-Nausea Medications to Avoid

Serotonin (5-HT3) antagonists work to block the effects of serotonin to reduce nausea and vomiting and do not worsen symptoms of Parkinson's. Ondansetron (Zofran), dolostone (Anzemet), and granisetron (Granisol) are acceptable alternatives to the list below. Older and cheaper anti-nausea medications block dopamine, therefore worsening Parkinson's symptoms. The following should be avoided:

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• Metoclopramide (Reglan)

• Phenothiazine (Compazine)

• Promethazine (Phenergan)

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Medications to Avoid if you take Rasagiline (Azilect) or Selegiline (Eldepryl)

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• Pain medications meperidine (Demerol), tramadol (Ultram), and methadone

• Antispasmodic medication (Flexeril)

• Dextromethorphan (cold medication) and ciprofloxacin (antibiotic)

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