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Dr. Okun

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Dr. Okun last won the day on October 4

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About Dr. Okun

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    Advanced Member

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  • Website URL
    http://movementdisorders.ufhealth.org

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  • Location
    University of Florida
  • Interests
    Parkinson disease and movement disorders

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  1. Hello. Is it said that people with parkinson are more likely to die on high temperatures . Why is so ? How the mechanism works ? 

  2. Dr. Okun

    slowing progression of PD

    The best place is pubmed which you can search on google.....this will allow you to search these topics in the medical literature.
  3. Dr. Okun

    curling of toes

    You may try lower doses or maybe be screened for a pump or DBS.
  4. Dr. Okun

    Rigidity and dyskinesia

    There are many options. Some people would reduce sifrol dose slightly or maybe even try to wean off; others may adjust Sinemet dose....another option at some point is a pump or DBS.
  5. Dr. Okun

    dizzyness and drugs

    Hard to know if the ropinerole, but it is possible....you may slightly reduce the dose and see if this helps....unclear why this can happen over time....but PD is a dynamic disease.
  6. Dr. Okun

    Stutter Steps

    You are correct that stutter steps or chasing your center of gravity (festination) is not always a dopamine off state....
  7. Dr. Okun

    Canabis and st. John Wort

    Great question. I am not aware of an interaction but the best thing is to ask your doc for permission. If they say yes, monitor for a few weeks and report any possible drug-drug interactions. I know drugs like Zoloft and regular SSRI's are ok with cannabis and that may be an option too.
  8. Good luck.
  9. Dr. Okun

    Rasagiline??

    Tough question on whether it makes a difference; the jury is still out. One other option that is cheaper is selegiline 5mg in morning and 5mg at lunch. This is the equivalent dose. They are slightly different MAO-B inhibitors and the study designs of what has been published also differ slightly.....but generic is much cheaper in most cases.
  10. Dr. Okun

    Rigidity and dyskinesia

    We generally adjust meds first; both dose and interval. We try to slightly reduce dose of either sinemet or sifrol and possibly add amantadine for dyskinesia. Decreasing Sinemet dosing and moving intervals closer together in time can also be helpful. At some point a pump or DBS may also be an option.
  11. Dr. Okun

    Dopamine Agonist Effectiveness Over Time

    Thank you and good luck.
  12. Dr. Okun

    curling of toes

    Yes, if on the other side of the body the PD may be progressing. Note that in almost every patient if I look hard enough I can find symptoms on both sides of the body.
  13. Dr. Okun

    Missing Meds

    We usually stop meds 12 hours before the appointment and get a UPDRS scale off. We then give meds and remeasure benefits. Short answer 12 hours is usually an ok interval.
  14. Dr. Okun

    Urinary tract infections

    I have not seen a specific study but yes I believe they are more common in men and women with PD. Best to see a urologist and they can give you lots of tips and also make sure by bladder ultrasound you are emptying the bladder. They can also help if you need more frequent urine tests and cultures and specific changes in habits. It all depends on the individual situation. Most urologists try not to use prophylactic antibiotics as this can lead to resistance.
  15. Dr. Okun

    slowing progression of PD

    So far the short answer is no. There is debate about the 1mg rasagiline dose which may have shown delay in progression. The debate is that the 2mg dose did not (New England Journal).
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