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Originally Posted by Tart Cherry Jam
Rose, let me message him and ask him what he meant. I got the impression from him that this ability to distinguish between drug-induced Parkinsonism and idiopathic Parkinson's is new. Doctors did not have it in the past. I just did not engage in a discussion about it because in my case it is so clear: I stop the offending drug and the symptoms evaporate. But I will ask him. I am just wondering if what he had in mind is newer than what was described in the tedious literature you tried to read.
I also would like to let you know that it seems to be the case that taking large doses of vitamin B6 plus a regular dose of a B vitamin complex does away with mild Parkinsonism that I experienced on Latuda. I am now switching from Latuda to Vraylar (a starter dose) for completely different reasons, but just in case I will keep taking B vitamins. My psychiatrist researched the issue and recommended B6 to me. I take 350 mg.
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It's certainly possible that your neurologist is more on the cutting edge of things than what I was reading. It's also possible that I misconstrued what I skimmed through.
As I understand it, Parkinsons is not easy to diagnose. Just yesterday I heard from a relative whose elderly friend is suspected of maybe having it, but doctors aren't sure. Compare Parkinsons with a CVA or "stroke." Having had a CVA is usually pretty obvious. But the symptoms of Parkinsons can go on for years before the diagnosis is arrived at. At least, that used to be true. Maybe it's changed. Muhammed Ali had what was eventually diagnosed as Parkinsonism, probably related to head trauma. In retrospect, we can now hear on taped interviews that his speech clearly showed neuro-degeneration years before he was given any diagnosis. Perhaps the Parkinson's Syndrome that he displayed was not true Parkinson's disease, but does it really matter? It was disabling and severely worsened over time.
Somewhere in Wikipedia, I read that drug induced Parkinsonism is quite stable and does not progress in severity as does Parkinson's disease, which seems to accord with what your neurologist is saying. Another article from 2012 says that DIP tends to look different in about half the people who have DIP. Then it says that in the other 50 % of patients with known DIP, the symptoms are indistinguishable from true Parkinson's disease. Also, the symptoms may persist for years after discontinuing the offending medication.
I just read that "postural instability" does not present until late in the course of true Parkinson's disease. So, if it occurs as an early feature of a patient's Parkinson-like symptoms, then the disorder is more likely Parkinsonism, rather than actual P.D. That also seems to accord with what your neurologist is saying.
I also just read that persons with DIP usually recover, after stopping the causitive drug, though recovery sometimes takes up to 2 years.
In conclusion, I guess your doctor knows what he's talking about. Still, I'm unconvinced that doctors can always, reliably distinguish Parkinsonism from true Parkinson's disease. It may be that such a distinction is clear in some cases and not so clear in others.