by Michael Wilenski

Michael Wilensky, MD, is a neurologist in private practice in Kenner, Louisiana. He also serves as the Clinic Director for the Louisiana Chapter Ataxia Clinics. Dr. Wilensky's talk, "Problems and Pills," was about some of the problems patients with ataxia face when common medicines are prescribed. He selected medicines that are commonly used to treat symptoms, not to treat or try to reverse the ataxia.

One of the big problems with medication and patients with ataxia (or patients with any neurological disease) is blurred vision. One of the most common causes for blurred vision is medication. Ataxia is basically a central nervous system disease and medication that affects the central nervous system will affect those with ataxia much more that the "normal" individual.

Ataxia patient's central nervous systems will not react in the same way to medications that other patients do. There is a sensitivity to psychotropic medications; any kind of narcotics, pain killers, tranquilizers, sleeping pills and alcohol. Ataxia patients do not have a normal nervous system and, therefore, their tolerance to what would be a normal dose of medication is not he same. The duration of drug action is considerably longer in an ataxia patient than in a normal individual.

Adverse effects and opposite effects are very common in many medications with any kind of central nervous problem. Dr. Wilensky said, " We commonly talk about medications in what are half life. A medicine that has a short half life (half life means time that it takes for half of that medicine to get out of your system) will work very quickly to get started and also disappear out of your system quite rapidly. It will only be effective for a very short period of time. A short acting medicine means you need multiple pills throughout the day. If the normal dose is three to four pills a day, ataxia patients may only need one to two a day."  Long acting medication lasts much longer throughout the day but it takes a lot longer to get started. Side effects of long acting medicine last a lot longer, even several days until completely out of your system.

"A lot of you are saying, 'Why, do I have to know all this, the doctors know this?' The problem is a lot of your family doctors do not know what ataxia is and they are not familiar with the effect of different medications on ataxia, so it is up to you to be familiar with the medications you take and some of the other problems that occur."

Dr. Wilensky went on to discuss muscle relaxers, antidepressants, sleeping pills, etc. This information will be published in a future issue of "Generations".

Reprinted with permission of NAF, from "Generations" Volume 23, Number 1, Spring 1995.

*Note: this article is for general information and should not be a substitute for consulting your own doctor.