Brief Answer: Medications will not change his general condition Detailed Answer: Hello, My name is Vinay Bhardwaj. Let me see if I can divide the problems your patient is having into two categories I) Parkinson's related issues. II) General Health Care issues. The Medications that he is on Syndopa, Syndopa Plus, Amantrel, Pacitine and Neurobion, are all good drugs and it depends from person to person what combination of medication will work the best. Also these things change as the disease progresses. There are no newer meds currently available on the market and the primary management through medication is only this much II) General Health issues on the other hand are what seem to be troubling your patient the most. What you are describing.. The weight loss, weakness, bed wetting and difficulty walking are indirectly caused by the disease, but there is NO medical treatment here. General care needs to be given Weight Loss: A high Protein, High energy diet must be given. Many times parkinsons patients have difficulty eating by mouth. In that case the patient may need evaluation for a PEG tube (A device which allows you to feed the patient through the abdomen directly). That way they can be fed in small doses throughout the day without the trouble of eating. If they still wish to eat they can, even with the PEG tube, so it takes nothing away. The Weakness: Needs to be addressed by a good physical therapist. The main reason the patient has lost so much weight is due to loss of muscle and lower metabolic rate. A PT will guide the patient in Active and conduct Passive exercises to help rebuild muscle and keep good range of motion for the patient. The fact that he is walking on his toes may mean that already the patient has developed contractures in the legs. Find a good PT and make sure the patient is seen at least 3 days a week for regular exercise. The patient should be able to do self directed exercises on the off days. Bed Wetting: Many times it is a good idea to have a nurse place a condom catheter or a foley catheter to keep the patient clean. If a more permanent solution is needed then you may be able to opt for a silicon foley catheter which can be kept in place for up to a month at a time. These things are certainly not ideal. But it is much better than allowing the skin to get damaged and infected from regular soiling of the clothes. These are some of the ideas I have that may help your brother. I wish I could say that some new ed will fix all these issues. but in this case it will take good nutrition and exercise to help him. I hope this helps. Feel free to follow-up on this. Vinay

---