Rivastigmine and Sinemet

[jawuk]

My husband who's currently in hospital has LBD with some Parkinsonian traits and has been on Rivastigmine for several years which saw off his former visual and aural hallucinations. He was seen yesterday by the Parkinson's specialist who is to have him transferred to rehab and has prescribed Sinemet, which contains levodopa and carbidopa, for him.

I read on the medication notes that Sinemet can cause hallucinations and delusions as a side effect and am quite concerned and wonder whether anyone has experience of this drug combination and any advice they might give me.

 

[Tinkerbelle258]

My husband who's currently in hospital has LBD with some Parkinsonian traits and has been on Rivastigmine for several years which saw off his former visual and aural hallucinations. He was seen yesterday by the Parkinson's specialist who is to have him transferred to rehab and has prescribed Sinemet, which contains levodopa and carbidopa, for him.

I read on the medication notes that Sinemet can cause hallucinations and delusions as a side effect and am quite concerned and wonder whether anyone has experience of this drug combination and any advice they might give me.

My husband was originally taking Aricept. When he was prescribed Sinemet last December the Aricept was changed to Rivastigmine as I was told that they "mixed" better, I was warned about hallucinations and was so worried that I almost withheld the Sinemet. However, he has been fine on them. Over the months doses of both drugs have been raised. Each time I am warned about the possibility of hallucinations but so far so good. Everyone reacts differently to drugs but you don't know how you will react until you try. It's scary but just because hallucinations are a possible side effect, it doesn't automatically follow that your OH will get them. Hope this helps.

 

[jawuk]

My husband was originally taking Aricept. When he was prescribed Sinemet last December the Aricept was changed to Rivastigmine as I was told that they "mixed" better, I was warned about hallucinations and was so worried that I almost withheld the Sinemet. However, he has been fine on them. Over the months doses of both drugs have been raised. Each time I am warned about the possibility of hallucinations but so far so good. Everyone reacts differently to drugs but you don't know how you will react until you try. It's scary but just because hallucinations are a possible side effect, it doesn't automatically follow that your OH will get them. Hope this helps.

Thanks for that reassurance Tinkerbelle. Does your husband have Lewy Bodies too and has he ever had hallucinations?

 

[Tinkerbelle258]

Thanks for that reassurance Tinkerbelle. Does your husband have Lewy Bodies too and has he ever had hallucinations?

I don't know what kind of dementia my husband has. Vascular was ruled out, then after a lumber puncture Alzheimers was ruled out (something to do with what wasn't found in the spinal fluid). So it's always just been described as dementia. I do sometimes think he has some of the symptoms of Lewy Bodies but not enough to merit an official diagnosis. He has only once had hallucinations, prior to diagnosis, and they weren't proper hallucinations, more him thinking he was somewhere else.

 

[nicoise]

Dear Jawuk,

My mum had Parkinson's, then latterly LBD.

So she had already been through pretty well every PD medication already, finally culminating with Sinemet, 7 doses a day.

The PD, and all the medications for it, and LBD, seem to give rise to lots of unpleasant symptoms and side-effects, and it can be difficult to differentiate between what might be a disease symptom or medication caused problem.

And hallucinations seem to be par for the course, although whether of a worrying nature or not comes down to the individual. My mum's hallucinations didn't cause her fears or worries, so I just ran with that.

She found that the Rivastigmine (patches) helped clear her "fuzziness", so for her it was a benefit. The tablets did not agree with her at all though, they gave her bad stomach problems. There was no worsening of hallucinations.

Best to just give it a go, perhaps keep a diary, and see how your husband gets on. The Sinemet allowed my mum's body to function, so the pay-off between side-effects and benefits was a necessary price to pay.

 

[trish54]

Hello! my husband has dementia and has been prescribed Rivastigmine (exalon). He is on the lowest dose.He has had the patches for 3 weeks and he is starting to show signs that his personality is coming back. He days that he feels better and his depression is lifting.
I have Parkinson's and have taken Sinemet along with other dopamine medication for 20 years.I have never had hallucinations. Xx

 

[jawuk]

Dear Jawuk,

Best to just give it a go, perhaps keep a diary, and see how your husband gets on. The Sinemet allowed my mum's body to function, so the pay-off between side-effects and benefits was a necessary price to pay.

I'll take your advice nicoise and start a diary of any changes, particularly if the hallucinations return which is what I'm most concerned about. Thanks

 

[jawuk]

Hello! my husband has dementia and has been prescribed Rivastigmine (exalon). He is on the lowest dose.He has had the patches for 3 weeks and he is starting to show signs that his personality is coming back. He days that he feels better and his depression is lifting.
I have Parkinson's and have taken Sinemet along with other dopamine medication for 20 years.I have never had hallucinations. Xx

Hi Trish54. My husband suffered from visual and aural hallucinations until he went onto Rivastigmine after which they entirely disappeared. My concern is that taking Sinemet might cause them to return as it's a known side effect.

 

[Rathbone]

Just read this thread jawuk and although I have nothing useful to add, I wanted to let you know I am thinking of you and sending love and a big hug. X Shelagh