Why do some people with Parkinson’s disease feel that their medication is not working?

  Parkinson’s disease is a degenerative disease of the central nervous system, with symptoms that progress slowly and worsen over time. If medication is not taken scientifically and reasonably, the patient’s symptoms will not be effectively controlled and the disease progression will not be slowed.  Why do some people with Parkinson’s disease feel that their medications are ineffective?  One of the most neglected factors affecting the efficacy of Parkinson’s disease medication is food. Some patients come to our hospital for the first time and have been seen elsewhere before, and some have even seen multiple hospitals and taken Parkinson’s disease medication, but their main complaint is that they “feel no effect.  If you are taking Parkinson’s disease drugs and feel no effect, you need to analyze the reasons, generally consider these three reasons, one, consider whether the diagnosis is clear, for primary Parkinson’s disease. Secondly, is the dose too small for the patient’s current condition? The third is, is the medication taken for a short period of time before and after eating?  Generally speaking, primary Parkinson’s disease is effective with compound levodopa drugs because Parkinson’s disease is due to the degeneration of the substantia nigra in the brain, resulting in a decrease in the production of a dopamine neurotransmitter, which cannot maintain the normal needs of the body, so that abnormal limb movement symptoms occur. The role of the compounded levodopa drugs is to replenish the dopamine neurotransmitter and maintain the body’s needs.  The second reason is whether the dose is small for the patient’s current condition. If the patient’s condition is serious, giving a small dose of medication will not control the symptoms well, and for patients with high expectations, it means “I don’t feel much effect after taking the medication”. Each patient is an individual and should be given “individualized and precise medication”, taking into account the patient’s age, symptomatology, severity of the disease, duration of the disease, etc., to reasonably adjust the medication.  The third reason is whether the medication is taken within a short period of time after meals. Parkinson’s disease drugs are effective on an empty stomach, because fasting allows the drug to fully contact the intestinal mucosa, using gastrointestinal peristalsis to fully decompose and absorb the drug, through the blood to the brain, to give full effect.  If the drug is taken within a short period of time after eating, it will make the food compete with the drug when it is absorbed through the intestinal mucosa. Moreover, the breakdown of proteins in food into amino acids significantly affects the passage of levodopa through the blood-brain barrier to the brain for action. This result has been verified by expert trials.  Some patients also report stomach discomfort, nausea, difficulty, and vomiting when taking Parkinson’s disease drugs on an empty stomach, which can be resolved by changing the dose of the drug or changing the dosing habits. It has been found that most people with Parkinson’s disease do not have significant gastrointestinal reactions when the medication is given in small doses and slowly increased according to the disease. If a small dose is given with a large reaction of stomach discomfort, the gastrointestinal disorder should be investigated.  Finally, we suggest a reasonable time to take the medication. Take the medication in the morning on an empty stomach, about 1 hour before meals, and about 2 hours after eating. We hope that patients will plan their diet and medication time according to this suggestion, so that the medication and food can fully enter the body and play their respective roles.