Is increased tremor in my father with Parkinson’s a concern?

Question

Hello doctor,

My father is 67 and was diagnosed with early-stage Parkinson’s disease last year. He is currently taking Carbidopa-Levodopa, which has been helpful, but recently we have noticed increased hand tremors and slower movements.

Is this a normal progression of the condition, or can the medication become less effective over time?
We are also concerned about possible side effects like hallucinations or sudden sleep episodes. Are these common with this treatment?
Additionally, does physical therapy or regular exercise help in slowing disease progression? He tries to walk daily but gets fatigued quickly.
We have been reading about deep-brain stimulation. At what stage is this typically considered?
Lastly, are there any newer medications or ongoing research developments for Parkinson’s disease that we should be aware of?

Our goal is to help him maintain his independence and quality of life for as long as possible.

Please suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for reaching out.

First of all, what you are noticing can be part of the normal course of Parkinson’s disease (a progressive brain disorder that affects movement, causing tremors, stiffness, and slow movements over time). Over time, tremors and slowness may gradually increase.

It does not necessarily mean the medicine has stopped working. With Carbidopa-Levodopa, many patients experience something called a wearing-off effect, where the benefit does not last as long between doses as it used to. His neurologist (brain specialist) can usually help by adjusting the dose or timing.

Regarding side effects like hallucinations or sudden sleep attacks. Yes, they are possible, but they are not very common in everyone. Still, if you notice any confusion, unusual behavior, or sudden sleep episodes, it is important to inform his doctor promptly rather than waiting for the next visit.

Now, about exercise and physiotherapy. This is extremely important in your father’s condition. While it may not stop disease progression, it greatly helps with.

Improving movement and flexibility.
Maintaining balance.
Supporting daily activities.

Even simple activities like regular walking, stretching, or guided physiotherapy can make a big difference in keeping him independent for longer. If he gets tired easily, his routine can be adjusted to shorter, more frequent sessions.

As for deep-brain stimulation (a treatment that uses implanted electrodes to send electrical signals to specific brain areas to help control abnormal activity), doctors usually consider it when medications are no longer controlling symptoms well or when side effects become difficult to manage. This is typically after several years of treatment, not in the early stages.

Lastly, yes. There is ongoing research and newer treatments being explored for Parkinson’s disease. The best approach is to stay in regular touch with his neurologist, who can guide you on the latest options based on how his condition progresses.

You are doing the right thing by being proactive. Supporting him with medication, activity, and regular follow-ups can really help him maintain independence and quality of life.

I hope this helps.

Please revert in case of further queries.

Thank you.