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Thank you, Hans, for pointing this out. This is a very timely publication by the AAN, based on careful review of the literature by experts in Parkinsonism It emphasizes that levodopa (Sinemet, SinemetCR, Madopar) is still the most potent and effective drug for the symptoms of Parkinsonism. It further clarifies that the claim that the agonists have made to reducing dyskinesias in the long run has got to be balanced against the greater risk of other side effects, such as hallucinations, somnolence, and edema with the agonists, in addition to the fact that they are weaker than levodopa in their ability to improve the symptoms of Parkinson's. Jorge A Romero, MD ----- Original Message ----- From: "Hans van der Genugten" <[log in to unmask]> To: <[log in to unmask]> Sent: Friday, January 11, 2002 8:23 PM Subject: Fw: AAN Practice Parameter for Early PD > Practice parameter: Initiation of treatment for Parkinson's disease: An > evidence-based review (Report of the Quality Standards Subcommittee of the > American Academy of Neurology) > JM Miyasaki, W Martin, O Sucherowsky, WJ Weiner, AE Lang > Neurology 2002;58:11-17 > > The authors reviewed the literature concerning initiation of PD treatment > from 1966 to 2000, selecting and analyzing results from prospective > studies only to develop conclusions regarding efficacy of different > treatment options. They conclude: > > --Selegiline has a mild symptomatic effect with no convincing evidence for > either neuroprotection or increased mortality. > > --Levodopa, cabergoline, pramipexole, and ropinirole are effective for > reducing motor and ADL disability, with levodopa being more effective than > the other agents. > > --Cabergoline, pramipexole, and ropinirole reduce the risk of motor > complications compared to levodopa, but are associated with a higher > incidence of adverse events including hallucinations, somnolence, and > edema. > > --The incidence of motor complications is not affected by the use of > sustained-release versus immediate-release levodopa. > > Copyright 2001 WE MOVE > Editor: Richard Robinson ([log in to unmask]) > > This service is provided free of charge to the Internet community, > courtesy of WEMOVE.org. This document may be freely redistributed by > email only in its unedited form. We encourage you to share it with your > colleagues. > > Patient subscribers: Information presented in the above article(s) > should not in any way be interpreted as medical advice. Please contact > your physician if you have questions about the information presented by > the E-MOVE news service or archives. It is not possible, nor is it > appropriate for WE MOVE to respond directly to questions regarding > medical management, including diagnosis and treatment. > > E-MOVE archives, plus information on subscribing, are > available at http://www.wemove.org/emove. > To unsubscribe, send an e-mail to [log in to unmask], > with "unsubscribe e-move" in the message body. > > E-MOVE is a service of WE MOVE (Worldwide Education and Awareness for > Movement Disorders) > 204 West 84th Street > New York, NY 10024 > > TEL 800-437-MOV2 > TEL 212-875-8312 > FAX 212-875-8389 > http://www.wemove.org > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: mailto:[log in to unmask] > In the body of the message put: signoff parkinsn ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn