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Baclofen and Ativan

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Dr Okun,


Is Barclofen good for stiffness in PD?  Mark the Pharmacist seems to recommend it and he takes it himself.  Are there any drawbacks or anything to look out for while on it?  I want to suggest this to my mom's doctor on our next visit.


My mom's anxiety level is getting higher and stiffens up when she's scared  (this type of stiffness is different case than what I mentioned above).  What can be taken safely for that? 


I remember long ago she was prescribed Ativan to sleep better at night.  It did the opposite and she was hyper instead.   This got me thinking that maybe she can take it to make her stay awake since she's just so out of it from taking Stalevo and Mirapex.  What do you think?  Her doctor said no to Ritalin fearing it will cause a heart attack.



3 things -


1- Stiffness

2- Anxiety

3- Wake up



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For stiffness in Parkinson's disease we do have much effectiveness from baclofen in most cases.  We treat with optimization of dopaminergics and also an examination for underlying arthritis.  For anxiety in patients who have trouble with benzodiazepines we optimize the dose and interval of dopaminergics (usually moves doses closer) and get a psychiatrist in board.  For Parkinson's sleep if there has been a bad reaction to a benzodiazepine I usually get a sleep study and consider other medications like trazodone.

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