Psychiatria pre prax 2/2004

NCREASED DAYTIME SOMNOLENCE AND ATTACKS OF SUDDEN FALLING ASLEEP IN PATIENTS WITH PARKINSON’S DISEASE

Increased daytime somnolence and attacks of sudden falling asleep in patients with Parkinson’s disease. Did it come a time for a general consensus regarding a capability to drive the motor vehicles? The capability to drive the motor vehicles in patients with the Parkinson’s disease (PD) is potentially risky with regards to the used medication and other signs, which are specific for this disease. Sleep disturbances and increased daytime somnolence are very common in patients with the Parkinson’s disease and all dopaminergic drugs have side effects as insomnia and daytime somnolence. Attacks of sudden falling asleep at steering wheel in all 8 patients with PD on a pramipexole and in one patient taking a ropinirole, with all patients causing traffic accidents, has brought out a discussion on topic of dopaminergic treatment influence on patients with PD. Problem of excessive attacks of falling asleep is more complex and of multifactorial origin. So the question is, whether the problem of driving a motor vehicle in patients with PD does not necessitates a statement in a form of general consensus after a discussion in a professional medical society and in public. Therefore it is necessary to carry out a careful survey of real risk of traffic accidents among drivers with PD. Meantime it is more than necessary to advise patients driving motor vehicles on increased risk of car accidents.

Keywords: Parkinson’s disease, dopaminergic stimulation, increased daytime somnolence, episodes of sudden falling asleep, driving the motor vehicles.