Medications to Avoid or Use with Caution
It can be challenging to keep track of all your medications, especially if you’re using medications for both motor and non-motor symptoms. However, keeping an accurate up-to-date list of your medications decreases the likelihood of an unwanted medication interaction. Studies have found that one in three people with Parkinson’s have been prescribed contraindicated drugs while they were hospitalized, which highlights the importance of having an up-to-date list of medications available at all times.
MAO-B Contraindicated Medications
Most prescription antidepressants have a potential interaction with MAO-B inhibitors. Prescription antidepressants have been used safely in thousands of people with Parkinson’s, but your prescribing physician may need to inform the pharmacy if they consider the benefits to outweigh the risks.
Generic Name |
Trade name |
|---|---|
| Meperidine (pain medication) | Demerol |
| Tramadol (pain medication) | Ultram |
| Methadone (pain medication) | Dolophine |
| St. John’s Wort (antidepressant) | Several brands |
| Cyclobenzaprine (muscle relaxant) | Flexeril |
| Dextromethorphan (cough suppressant) | Robitussin, other brands |
| Pseudoephedrine (decongestant/stimulant) | Sudafed |
| Phenylephrine (decongestant/stimulant) | Vicks Sinex, etc. |
| Ephedrine (decongestant/stimulant) | Emerphed, Akovaz, etc. |
| Linezolid | Zyvox |
| Phenelzine | Nardil |
| Tranylcypromine | Parnate |
| Isocarboxazid | Marplan |
First-generation antipsychotics
These medications block dopamine receptors in the brain, thus countering the desired effects of Parkinson’s medications and likely worsening Parkinson’s motor symptoms.
Generic Name |
Trade Name |
|---|---|
| Loxapine | Loxitane |
| Pimozide | Orap |
| Fluphenazine | Prolixin |
| Trifluoperazine | Stelazine |
| Haloperidol | Haldol |
| Chlorpromazine | Thorazine |
| Thiothixine | Navane |
| Perphenazine | Trilafon |
| Thiothixine | Mellaril |
Second-generation antipsychotics
These medications block dopamine receptors in the brain, thus countering the desired effects of Parkinson’s medications and likely worsening Parkinson’s motor symptoms. These medications block less dopamine than first generation antipsychotics, but they should nonetheless be avoided.
Generic Name |
Trade Name |
|---|---|
| Lurasidone | Latuda |
| Asenapine | Saphris |
| Olanzapine | Zyprexa |
| Aripiprazole | Abilify |
| Iloperidone | Fanapt |
| Cariprazine | Vraylar |
| Risperidone | Risperdal |
| Brexpiprazole | Rexulti |
| Ziprasidone | Geodon |
| Paliperidone | Invega |
Antiemetics
These medications treat nausea by blocking dopamine receptors in the brain, thus countering the desired effects of Parkinson’s medications and possibly worsening Parkinson’s motor symptoms.
Generic Name |
Trade Name |
|---|---|
| Prochlorperazine | Compazine |
| Chlorpromazine | Thorazine |
| Promethazine | Phenergan |
| Metoclopramide | Reglan |
| Droperidol | Inapsine |
Treatments for Hyperkinetic Movements
These medications are used for a condition called tardive dyskinesia, which is different than levodopa-induced dyskinesia. These medications lower dopamine, possibly worsening Parkinson’s motor symptoms.
Generic Name |
Trade Name |
|---|---|
| Tetrabenazine | Xenazine |
| Valbenazine | Ingrezza |
| Deutetrabenazine | Austedo |
Antihypertensives
These medications reduce dopamine, possibly worsening Parkinson’s motor symptoms.
Generic Name |
Trade Name |
|---|---|
| Reserpine | Serpalan |
| Methyldopa | Aldomet |
Antidepressants
Amoxapine is a TCA but unlike other TCAs also blocks dopamine receptors. Phenelzine, isocarboxazid, and tranylcypromine are nonselective MAO inhibitors and cannot be taken in conjunction with MAO-B inhibitors.
Generic Name |
Trade Name |
|---|---|
| Amoxapine | Asendin |
| Phenelzine | Nardil |
| Isocarboxazid | Parnate |
| Tranylcypromine | Marplan |