Image

Medications to Avoid or Use with Caution

About These Medications

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.

Medications Contraindicated for use with MAO-B Inhibitors


Most prescription antidepressants have a potential interaction with MAO-B inhibitors used to treat Parkinson’s. 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 NameTrade 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
IsocarboxazidMarplan

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 NameTrade Name
LoxapineLoxitane
PimozideOrap
FluphenazineProlixin
TrifluoperazineStelazine
HaloperidolHaldol
ChlorpromazineThorazine
ThiothixeneNavane
PerphenazineTrilafon
ThioridazineMellaril

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 NameTrade Name
LurasidoneLatuda
AsenapineSaphris
OlanzapineZyprexa
AripiprazoleAbilify
Iloperidone Fanapt
Cariprazine Vraylar
RisperidoneRisperdal
BrexpiprazoleRexulti
ZiprasidoneGeodon
PaliperidoneInvega

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 NameTrade Name
ProchlorperazineCompazine
ChlorpromazineThorazine
PromethazinePhenergan
MetoclopramideReglan
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 NameTrade Name
TetrabenazineXenazine
ValbenazineIngrezza
DeutetrabenazineAustedo

Antihypertensives


These medications reduce dopamine, possibly worsening Parkinson’s motor symptoms.

Generic NameTrade Name
ReserpineSerpalan
MethyldopaAldomet

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 NameTrade Name
AmoxapineAsendin
PhenelzineNardil
IsocarboxazidMarplan
TranylcypromineParnate