Course of Parkinson Disease When to Use Specific Drugs

Controversy exists as to when specific anti-Parkinson drugs should be employed.1,16 Much of the debate focuses on when levodopa therapy should be initiated. Without question, levodopa is the most effective pharmacological treatment for reducing the motor symptoms of Parkinson disease. As mentioned previously, however, long-term use of levodopa poses several risks, and the effectiveness of this drug seems to diminish after several years of use. Consequently, some practitioners question whether levodopa therapy should be withheld until the parkinsonian symptoms become severe enough to truly impair motor function. In theory, this saves the levodopa for more advanced stages of this disease, when it would be needed the most.48 

There is no clear consensus of which drugs should be used in the initial and subsequent treatment of Parkinson disease. Future research should help clarify whether it is better to begin treatment with dopamine agonists, and to save levodopa and other medications until later in the disease course. Ultimately, the physi- 

The cause of Parkinson disease remains unknown. However, the neuronal changes that produce the symptoms associated with this movement disorder 

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Clinical Course of Parkinson Disease When to Use Specific Drugs... 

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