PARKINSONS & PARKINSONISM-FATIGUE

SUMMARY

1. Level 1 evidence lacking for pharmacological as well as non pharmacological interventions.

PHARMACOLOGIC MANAGEMENT
2. Dopamine agonists may be better than L-dopa to target fatigue: Ropinirol, Pramipexole.
3. TCA especially if depression is suspected, specifically Doxepin may help with ADL related fatigue.
4. No role for stimulants.
5. Rivastigmine may help with apathy

NON-PHARMACOLOGIC MANAGEMENT
6. Graded exercice program.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].