Overview

Most people know that Parkinson's disease is a condition that affects how you move. But the breakdown of nerve cells in Parkinson's disease can cause other symptoms. These other symptoms, also called "non-motor" symptoms, include:

• Constipation. This is a common problem, mostly related to the breakdown of the nerve cells that control involuntary body functions (the autonomic nervous system). Some medicines for Parkinson's disease can also cause constipation. To avoid constipation:
  • Include fruits, vegetables, beans, and whole grains in your diet each day. These foods are high in fibre.
  • Drink plenty of fluids, enough so that your urine is light yellow or clear like water.
  • Get some exercise every day, if possible.
  • Take a fibre supplement, such as Prodiem or Metamucil, every day if needed. Read and follow all instructions on the label. Your doctor may suggest you use a medicine like polyethylene glycol (for example, Pegalax) to help with constipation.
  • Schedule time each day for a bowel movement. Having a daily routine may help. Take your time and do not strain when having a bowel movement.
• Sexual problems, including erection problems, reduced sensitivity, and difficulty reaching orgasm. These can be caused by the disease itself, medicines used to treat the disease, and mood problems like depression. Some sexual problems can be treated with a change in medicine or counselling. Men may be able to use sildenafil (Viagra) for erection problems.
• Dizziness, light-headedness, and fainting. This is caused by low blood pressure, especially when moving from a sitting or lying position to standing (called orthostatic hypotension). Many of the medicines used to treat Parkinson's disease can make the dizziness worse. Your doctor may be able to suggest things that can help. Drinking enough water (more than 2 liters a day) is an important first step.
• Urinary incontinence. In Parkinson's disease, this can be caused by changes in how your bladder fills and empties. Parkinson's disease can also change how well you can feel that your bladder is full. Your doctor may be able to recommend lifestyle changes or medicines that can help with urinary incontinence.
• Excess saliva and drooling. Changes to the muscles of the face can cause problems with eating and swallowing. You may be able to control this problem by changing what and how you eat. A speech-language pathologist (also called a speech therapist) can teach you exercises and show you other ways to help with eating, swallowing, and drooling. Your doctor may also be able to suggest medicines that can control drooling if it is severe.
• Oily skin or increased dandruff.
• Sweating and intolerance to heat. These are also problems for people with Parkinson's disease. These symptoms are mostly related to changes to the nerves that control automatic body processes (like body heat).
• Sleep problems, including:
  • Excessive daytime somnolence (EDS), which means you fall asleep very easily during the day or feel very tired all the time. This can be caused by medicine used to treat Parkinson's disease and is worse with some medicines than with others. Your doctor may be able to switch your medicine or give you medicine to help you feel more awake during the day.
  • Insomnia. In Parkinson's disease, insomnia can mean that you have trouble falling asleep or that you wake up a lot during the night. Many things can cause problems sleeping, including medicines for Parkinson's disease or a tremor that keeps you awake. You may be able to change medicines or the amount of medicine you are taking to help with insomnia. Taking melatonin may also help.
  • Restless legs syndrome (RLS) and periodic limb movement disorder (PLMD). Medicines that are used to help with other Parkinson's disease symptoms, such as levodopa and dopamine agonists, can also help with RLS and PLMD.
  • Rapid eye movement (REM) sleep behaviour disorder (RBD). People with REM sleep behaviour disorder act out their dreams during the time they are in the stage of sleep called REM sleep. This can be dangerous to the person with the disorder and his or her bed partner. Your doctor may be able to suggest medicines that can help with RBD.
  • Fatigue. Many people with Parkinson's disease experience fatigue. If you are having fatigue that is overwhelming, tell your doctor. He or she may change the type of medicine you are taking for Parkinson's disease or change the amount you are taking. There are also medicines that can help treat fatigue in Parkinson's disease.
• Anxiety. Anxiety and depression often happen together in people who have Parkinson's disease. Some people may need medicine to control anxiety.
• Depression. Parkinson's disease can cause depression, and so can having a long-term, disabling illness like Parkinson's disease. Talk to people about how you feel. Your doctor may be able to suggest counselling or medicines to help.
• Psychosis. Some people in the later stages of Parkinson's disease have problems telling the difference between what is real and what is not real. Some of this can be caused by the disease, and some of it can be caused by medicines used to treat Parkinson's disease. Medicines can be used to treat psychosis if it is severe or dangerous.
• Dementia. Dementia may develop in up to one-third of people who have late-stage Parkinson's disease. Dementia symptoms may include disorientation at night, confusion, and memory loss.