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5 Stages of Parkinsons Disease

5 Stages of Parkinson’s Disease

Parkinson’s disease affects people in various ways, and those who live with the condition may not experience all of the typical symptoms. Those who share similar or identical symptoms may not necessarily have them simultaneously or experience the same intensity. It’s a disease that progresses uniquely from person to person, and the uncertainty of what might happen next can be very difficult for patients and their loved ones.

What Is Parkinson’s Disease?

Symptoms of Parkinson’s Disease

 Parkinson’s disease is caused by a loss of nerve cells in a part of the brain called the substantia nigra, leading to progressive damage to several areas of the brain over many years. The loss of nerves reduces dopamine in the brain, which plays a vital role in the body’s ability to move. This reduction of dopamine is responsible for several Parkinson’s symptoms, mainly motor symptoms, but the mechanism for losing nerve cells remains unclear. Most experts agree that it’s due to genetic and environmental factors.

The three typical movement symptoms of Parkinson’s disease are:

  • Involuntary shaking or a ‘tremor’ of parts of the body
  • Slow movement
  • Stiff muscles and difficulties with flexibility

Additionally, people with Parkinson’s disease can also experience other physical and non-movement symptoms, such as:

  • Depression and anxiety
  • Balance issues
  • Losing sense of smell
  • Sleeping problems
  • Memory difficulties

Many medical professionals who diagnose Parkinson’s disease use the Hoehn and Yahr scale to classify symptoms and their severity. This scale rates the condition and breaks it into five stages based on disease progression. The scale allows doctors to evaluate how far PD has advanced in patients and what treatments may be most effective for symptom management.

Stage 1

Changes in a Person’s Habits

At stage 1, there can be mild symptoms of Parkinson’s disease, but they’re often not severe enough at this point to impact daily tasks and general quality of life. However, this isn’t to say symptoms are not present. Family and friends may notice changes in a person’s movement, recognize poor posture, and see differences in facial expressions at this early stage.

Stage 2

Muscle Stiffness and Posture Problems

Stage 2 of Parkinson’s disease is considered a ‘moderate’ condition, with symptoms becoming more noticeable than in the previous stage. Examples include noticeable tremors, stiffness, and trembling. Also, changes to facial expressions can occur but are not always apparent to others. 

Although stage 2 doesn’t usually cause balance-related issues, other movement symptoms, such as muscle stiffness, can make tasks more challenging. Additionally, the condition can hinder a person’s posture at this stage, leading to back and neck pain. At this point, the disease can impact both sides of the body, and difficulties with speech can also occur.

Progression from stage 1 to 2 can take months to years, and there are no reliable methods to predict how it will progress. People in stage 2 of Parkinson’s can generally live alone but tend to find everyday tasks more difficult.

Stage 3

Poor Reflexes and Balance Issues

The third stage of Parkinson’s is considered mid-stage Parkinson’s progression and a significant turning point in how the disease will progress from here on out. While many of the symptoms remain the same or similar to stage 2, stage 3 can also introduce poorer reflexes and loss of balance at times. For this reason, people in stage three experience more noticeable movement issues or appear to ‘slow down.’ Unfortunately, falls become more frequent at this stage due to balance and reflex problems. 

Stage 4

Poor Motor Skills

Grandfather walking his granddaughter on a cemented road

The critical factor in separating people with stage 3 Parkinson’s and stage 4 is independence. Motor skills are heavily impacted at stage 4, and movement symptoms affect a person’s ability to retain their independence. Some people at stage 4 can stand confidently without assistance, and some can walk without the help of equipment or another person, but it’s common for a person to require assistive equipment such as a walker.

Stage 5

Severe Stiffness

Stage 5 of Parkinson’s disease is the final and most debilitating stage and reflects the most advanced progression. Severe stiffness can make it difficult, if not impossible, for a person to stand or walk. It is due to stiffness causing the legs to freeze when the patient attempts to stand essentially. These symptoms make daily tasks impossible and dangerous for someone to try without assistance. Therefore, it’s common for stage 5 sufferers to need a wheelchair because of an inability to stand without help — meaning they often require supervision to avoid falls.

Recommended medications for this type of disease may include:

These drugs are in a class of medications called dopamine agonists. It works by acting in place of dopamine, a natural substance in the brain needed to control movement.

Buy Ropinirole

Medications for People with Parkinson’s Disease

Ropinirole HCL is a prescription drug that helps improve the ability of patients with Parkinson’s disease to move, decrease shakiness, slowed movement, and unsteadiness. It’s the most preferred medications for older people with Parkinson’s disease because it causes fewer movements and mental fluctuations.

Ropinirole is also effective in treating restless leg syndrome and in lowering movement fluctuations for patients with Parkinson’s disease. It’s more popular than comparable drugs. You can use it alone or along with other medications in treating Parkinson’s disease.

What condition does Ropinirole treat?

Ropinirole HCL is a short-acting prescription drug used in treating:

How does Ropinirole work?

  • Ropinirole is a dopamine agonist type of drug that mimics the activity of a substance found in the brain called dopamine. Dopamine is a neurotransmitter involved in transmitting messages between nerves. The normal level of dopamine leads to the normal functioning of the body.
  • People with Parkinson’s disease are thought to have reduced or absent dopamine in the brain.
  • Ropinirole acts as a dopamine substitute. It works by stimulating dopamine receptors in the brain. This restores the dopamine activity and reduces the symptoms of Parkinson’s disease.

What is the dosage of Ropinirole?

The dose depends on the strength of the medicine and how well you tolerate the medicine.

  • The recommended initial dose for an adult with Parkinson’s disease is 2 mg once a day for 1 to 2 weeks. Your dose may be increased as needed. The maximum recommended dose should not be more than 24 mg a day.
  • The recommended dose for an adult with RLS is 0.25 mg a day 1 to 3 hours before bedtime. Your dose may be increased as needed. The maximum recommended dose should not be more than 4 mg a day.

How to take Ropinirole?

  • Swallow the tablet whole with plenty of water. Do not chew, crush, or split the tablet. You can take it with or without food but taking it with food may help reduce nausea.
  • You can’t stop taking Ropinirole all of a sudden. If you wish to stop your medication, you may have to inform your doctor especially if you have been taking it for a long time. Your doctor will have to reduce your medication gradually.
  • You can take Ropinirole alone or along with Levodopa to treat Parkinson’s disease.
  • Do not take or less than what is prescribed by your physician. If you will take too much, you could have a dangerous level of this drug in your body.
  • You should take it with or after food to reduce your risk of experiencing side effects like indigestion or nausea.
  • If you have missed a dose, take it as soon as you remember. Your medication will not work well if you will not take it on as scheduled.

What are the precautions in taking Ropinirole?

  • Use Ropinirole with caution among patients with:
    • Decreased kidney or liver functions
    • History of psychotic illness
    • Severe cardiovascular diseases
  • Do not use among patients who are:
    • Pregnant or breastfeeding
    • Children under 18 years of age
    • Have a rare hereditary problem of galactose intolerance, glucose-galactose malabsorption, or the Lapp lactase deficiency
  • Ropinirole is effective in treating the symptoms of Parkinson’s disease and RLS but it’s not the best choice if you have kidney problems and if you are an older person.
  • This drug can cause your blood pressure to drop especially during the first few days of your treatment. To prevent dizziness when getting up from lying or sitting position, try doing it slowly. Drinking alcoholic beverages may also increase your chance of feeling dizzy. Call your doctor if you have any symptoms of decreased blood pressure.
  • You may suddenly fall asleep while doing normal activities like driving without any warning while taking this medicine. Inform your doctor right away if this happens.
  • Another unwanted side effect of this drug is a hallucination and other psychotic-like behavior. Patients with Parkinson’s disease who are taking higher doses have higher chances of experiencing hallucinations.
  • Increased sexual urges, unusual urge to gamble, or an uncontrollable urge to shop, eat, or spend money are other unusual changes in behavior noticed among those who are taking this drug.
  • Patients who are taking this medication may have a higher chance of getting skin cancer.
  • Call the doctor right away in case of serious side effects like:
    • Changes in heart rate
    • Psychiatric effects such as hallucination, confusion, and paranoia
    • Low blood pressure
    • High fever
    • Muscle tightness
    • Fainting
    • Allergic reactions with signs like a rash, hives, difficulty swallowing, and trouble breathing
  • Ropinirole may interact with other medications. Be sure to inform your doctor about all your medications including those bought without prescriptions, vitamins, and herbal supplements.

Costs of Generic Ropinirole vs. Requip

Ropinirole is a cheaper generic medication compared with the brand name Requip.  It is prescribed to help people with Parkinson’s disease to move, decrease shakiness, slowed movement, and unsteadiness. Ropinirole 0.5 mg cost $0.66 per unit price or $65.99 for 100 tabs. While the brand name Requip 0.5 mg costs $2.14 per unit price or $214 for 100 tabs.