Yes, visual hallucinations are a common and an unwanted effect associated with Levodopa treatment in parkinson’s disease. It is in fact a severe side effect and it includes hearing, seeing or feeling various things, which do not remain present actually.
Hallucinations in parkinson’s disease patients are usually of visual type i.e. patients see things, which do not remain actually present. In addition, in some cases, patients may suffer from auditory hallucinations. Despite, hallucination is a common problem in advanced phase of parkinson’s disease; it may even surface in initial stage after patients start with taking medicines. These are central clinical features associated with parkinson’s disease dementia problem, but drug-induced type of hallucinations may even take place without dementia.
Hallucinations problem often manifest as animals or people. For example, viewing strangers out from the window, children in yard, animals in house are common forms of hallucinations with parkinson’s disease patients. In mild form of parkinson’s disease, this remains present simply in nondescript shape and out of eye corner or as crawling of bugs. However, insight will vary and a few people recognize absurdity associated with their illusions, while others intend to interact with illusory phenomena.
Hallucinations among Parkinson’s disease patients are of episodic and do not have any relationship with any provocative factor. As parkinson’s disease patients lack predictability, doctors recommend parkinson’s disease patients suffering from hallucinations to avoid driving their cars. Instead, they may resume driving only after when doctors clear to do so and satisfy that their problems related to hallucinations resolved completely. Most of the times, doctors opt to simplify medication and perform additional drug therapy to control hallucination problem.
In most of the cases, parkinson’s disease drugs have prominent roles to provoke delusions and hallucinations. However, doctors usually do not consider them as sole causes. Instead, they perceive that neurodegenerative procedure in case of PD predisposes and it may take place among patients, who do not intake any drug.
Clinical trials enrolling previously untreated patients of Parkinson’s disease revealed that dopamine agonists have 2 to 3 times higher ability in inducing hallucinations as compared to monotherapy with other medicines, such as levodopa and carbidopa. This is because of the presence of ropinirole, pramipexole and rotigotine, all of which come with selectivity for D3 type of dopamine receptor. D3 receptors localize primarily to behavioral and/or emotional circuits present in the patient limbic system.
After this, adjunctive type of drug therapy to deal with Parkinson’s disease substantially increase the risk related to delusions and/or hallucinations. Indeed, levodopa or carbidopa occasionally causes provoke of hallucinations, but you add any adjunctive drug, risks increase significantly. It not only includes dopamine agonists, but also MAO-B i.e. monoamine oxidase-B inhibitors and COMT i.e. catechol-O-methyl transferase inhibitors.
Doctors have even identified that the propensity to provoke delusions and hallucinations not remains confined to only dopaminergic type of parkinson’s disease drugs. Instead, the antagonists of NMDA i.e. N-methyl-D-aspartate and amantadine may even provoke hallucinations, as similar to any pharmacologically drug of Alzheimer disease. Even the anticholinergic parkinson’s disease medicines, such as benztropine and tryhexyphenidyl are notorious to impair memory and cause psychosis occasionally.
Other Side Effects of Levodopa
Now, let us have a look on a few side effects of levodopa medicine other than hallucinations.
Common Side Effects
- Holding of false beliefs or abnormal thinking, which does not change based on fact
- Anxiety and agitation
- Grinding or clenching of teeth
- Unsteadiness or clumsiness
- Confusion and dizziness
- Difficulty in swallowing
- Excessive retention of water in the mouth
- False sense associated with well being
- Feeling of faintness
- Feeling of illness or discomfort
- Increase in hand tremor
- Vomiting or nausea
- Numbness in hands and legs
- Uncontrolled and unusual body movements, including upper body, tongue, face, hands, arms and head
- Unusual weakness or tiredness.
Less Common Symptoms
- Difficulty in urination
- Blurred vision
- Difficulty in opening mouth
- Large and dilated eye pupils
- Lightheadedness or dizziness while getting from sitting or lying position
- Double vision
- Irregular, fast or pounding type of heartbeat
- Hot flashes
- Increase in eyelids spasms or blinking eyes
- Bladder control loss
- Mental depression
- Mental changes or mood swings
- Skin rashes
- Unusual weight loss or weight gain.
Rare Symptoms of the Problem
- Pain in back or in legs
- Black or bloody tarry stools
- Seizures/convulsions and chills
- Fever and sore throat
- High blood pressure
- Inability associated with eyes movement
- Appetite loss
- Tenderness, pain or swelling of legs or feet
- Pale skin
- Painful, prolonged and inappropriate erection of penis
- Stomach pain
- Swelling of lower legs or feet
- Swelling of face
- Vomiting with blood or any other similar material, appearing as coffee grounds.