A Question About Side Effects?
Question by shorts: a question about side effects?
My father takes stemetil and is worried about getting Parkinson disease ..I would like to know how much you would have to take to cause any problems such as this
Best answer:
Answer by alltheworldsastage07
I cannot give you advice concerning your father. In general, however, medications such as Stemetil are often monitored with regular blood work done in a laboratory. The physician will check the patient’s blood for toxic levels of medications to avoid tardive dyskinesia, which is a movement disorder.
Your concern for your father is commendable.
Answer by Mags
The problem with Stetemil (Prochlorperazine) also sold as Compazine, Stemzine, Buccastem and Phenotil is not that it causes Parkinson’s disease but that it causes symptoms which PD also shares.
The symptoms include dystonia, dyskinesia, tremors, rigidity, akathisia. One of the problems is that it can cause a persistent Tardive Dyskinesia which is described as “rhythmical involuntary movements of the tongue, face, mouth or jaw (e.g., protrusion of tongue, puffing of cheeks, puckering of mouth, chewing movements). Sometimes, these may be accompanied by involuntary movements of the extremities”
The problem is that this symptom often doesn’t abate if the medication is discontinued. The “good news” is that the symptom often occurs in elderly women patients.
Stemetil is a ” piperazine phenothiazine derivative with anti-psychotic, anti-emetic and weak sedative activity” It is used for agitation, confusion, delusion, anxiety associated with psychotic disorders. It is easily assimilated and acts withing 30 minutes if taken orally. It distributes throughout the body but concentrates in the liver and spleen.
The dosages will vary since this med is available in injectable, suppositories and oral tablets and we don’t know the form of your father’s medication, tt is difficult to determine the dosage amount which would be too much. It think that may depend upon how long he has been taking it and how it affects him. It is something he needs to discuss with the prescribing physician or he can get a second opinion if possible,
One of the things that worries me is that it is possible to buy this medication online without a prescription. That can mean that no one is watching for drug interactions, contraindications, blood, liver and renal levels or other side effects.
Although one source indicated that it was no longr made for marketing in Canada, I have see it offered for Canada. In the UK it is prescribed for nausea, vertigo, spatial & temporal jerking. In the US it is not approved by the FDA for treatment of older adults with dementia. It is prescribed for schizophrenia.
For patients taking this medication a long term basis, it is recommended that not only blood counts be conducted but also liver function tests. Renal function should also me monitored. This does not mean that these tests will be done unless the patient reminds the physician. Patients should be re-evaluated periodically to determine if dosage can be reduced, treatment discontinued or an alternate treatment be considered.
One action of Stetemil is as an anticholinergic, meaning that the it acts to inhibit the excitatory action of that neurotransmitter. Of note is that anticholinergics are seldom used for Parkinson’s disease treatment any more although they are used in low doses for swallowing issues when other meds don’t work for that symptom. Other sources indicate that it works in the mesolimbic system (not the substantia nigra) to block postsynaptic dopamine receptors. There is more involved in the process but that is the reason for the Parkinsonian-like symptoms.
Among the caveats are already having Parkinson’s disease, glaucoma. liver disease, jaundice, prostrate trouble, seizures, urinary issues, blood disorders. Those are probably conditions which would contraindicate the use of this medication
Other things to be concerned about are ocular issues: retina, corneal deposits. There are several other side effects from this type of medication.
Your father is right to be concerned about the medication because one difficult symptom of PD is dyskinesia.
Perhaps this is the time to discuss alternative treatments with his doctor especially if he has been on the med for awhile. Please remind him about the testing he should have just in case they haven’t been done.