Question

My husband has had Parkinson's for about 18 months. He finds he gets terribly tired all the time. Is this a common problem, and what can be done about it?

Answer

Chronic fatigue is, indeed, a common feature of Parkinson's disease; it just doesn't get the same attention as depression, but it can be almost as hard, or even harder, to treat. It's characterized by feelings of being tired, run-down, out of energy, unable to get started, and 'useless'. And it doesn't go away with a period of rest. About one in three Parkinson patients consider fatigue to be their single most bothersome symptom.
 

Fatigue in Parkinson's disease may be accompanied by depression, but not necessarily so. And it's not related to the severity of Parkinson's. It tends to occur early in the course of the disease, sometimes even before there is evidence of slowness or a tremor. Fatigued patients may also be sleepy, but sleep may or may not help; it's an approach worth trying, however, as is the treatment of any depression.
 

It's possible that one or other of the medications used to treat Parkinson's may be causing fatigue as a side effect in a particular patient; again, some trial and error may be necessary here to find out if there's a relationship.
 

Some doctors aren't sensitive to this particular symptom as a major problem. Ask your doctor about her/his views on this, and, if necessary, ask for a second opinion. Together with your doctor, you can try improving sleep, altering the Parkinson disease medications, treating any depression, and promoting an exercise program. Hopefully one or more of these steps will improve your husband's fatigue.
 

This reply was based on an article by Joseph H. Friedman, MD, in the American Parkinson's Disease Association educational supplement series (see first link below).
 

Related Links
APDA Educational Booklets
UK Parkinson's Disease Society: What is Fatigue?