WIRE: 06/11/2001 5:36 pm ET
Guidelines Stress Different Drugs for Parkinson's

NEW YORK (Reuters Health) - Most patients with Parkinson's
disease should first be treated with a class of drugs known as
dopamine agonists, according to new guidelines published on
Monday.

Roughly one million people in the US have Parkinson's, an
irreversible neurodegenerative disorder characterized by
tremors, loss of balance, slow movements and difficulty
thinking. The disease is caused by a steady loss of the brain
chemical dopamine and occurs when the dopamine-producing
cells in the brain that control movement begin to die.

Traditionally, patients have been treated with levodopa
(L-dopa), a drug that boosts levels of dopamine in the brain.
But over the long term, this drug can cause involuntary
movements of the mouth, face and limbs, usually on one side
of the body.

Dopamine agonists appear to control the symptoms of
Parkinson's disease without causing these long-term side
effects, particularly when given to patients in the early
stages of the disease, Dr. William C. Koller, director of the
division of movement disorders at the University of Miami in
Florida, told reporters.

"The key issue in the treatment of Parkinson's disease is
to maintain quality of life," he said. "[With dopamine
agonists] you can control the symptoms now and 10 years
from now and patients are just as functional, whereas with
levodopa, patients experience side effects [that may lead to]
embarrassment and patients become socially reclusive."

Koller stressed that Parkinson's is a complex disease and
doctors treating patients with the disorder should take into
account their individual needs. Very elderly patients and those
who have difficulty thinking might benefit from levodopa as a
first-line therapy, he said, as the drug is known to relieve
symptoms rapidly.

The guidelines are published in a supplement to the June
issue of Neurology.

SOURCE: Neurology 2001;56:suppl 5.

http://www.abcnews.go.com/wire/US/reuters20010611_307.html

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New treatment guidelines for Parkinson's disease
http://www.cnn.com/2001/HEALTH/conditions/06/11/parkinsons.guidelines/index.html

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