The Need to Address Nonmotor Symptoms in Parkinson Disease: Neal Hermanowicz, MD

WATCH TIME: 3 minutes

"Another top symptom that I hear all the time from my patients is the fatigue, and we don’t really have a good grasp on where it’s coming from. What do we do about that?"

In addition to motor symptoms such as slowness of movement, tremor, stiffness, and postural instability, patients with Parkinson disease (PD) face a list of other nonmotor symptoms that can have a significant impact on quality of life. They include things like constipation, cognitive changes, fatigue, hallucinations and delusions, loss of sense of smell or taste, vision problems, and sleep disorders, among others. Some of these symptoms can occur years before the diagnosis of PD.

The treatment toolbox for patients with PD is limited, especially for treating nonmotor symptoms. Pimavanserin (Nuplazid; Acadia Pharmaceuticals), a selective serotonin inverse agonist and antagonist, became the first FDA-approved medication for the treatment ofPD psychosis in 2016, and since then, there has been little other progress. Neal Hermanowicz, MD, a neurologist at Christus St. Vincent Health System, believes there needs to be more attention to the nonmotor symptoms, as many patients feel as though these symptoms are even more bothersome than the motor issues they face.

In an interview with NeurologyLive^®, he discussed the urgent need for new medications to treat motor and nonmotor symptoms of PD.