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When People Tend to Start Parkinson's Medications
 08/30/07  Treatment Options, Disease Basics, General
Should a Person Start Dopamine Right Away?
When to start dopamine replacement therapy is one of the biggest
controversies within Parkinson's disease, and physicians tend to have
different opinions on the issue.  Many patients and physicians opt to delay
using Sinemet, Parcopa, and other levodopa therapies until symptoms are more
pronounced.  Levodopa loses its effectiveness over time, so some people
prefer to preserve that effectiveness to later in the disease when they will
need it more.  Some physicians will start their patients on a dopamine
agonist, MAO-B inhibitor or an anticholergenic for use in the early stages.
There are more than a dozen anti-Parkinson's medications that address the
shortage of dopamine central to Parkinson's disease.  Your physician will
match medications to your particular needs.  There are some medications that
tend to be most useful at certain stages in Parkinson's disease.  The
following graphic outlines some approximate seasons within Parkinson's
disease when patients tend to start certain anti-Parkinson's medications and
use them the most.  It is intended for general information only. Many
physicians will introduce medications at times other than indicated on the
chart.

Some data indicates that people who start Levodopa early do better with
Parkinson's disease for a longer period of time.  Some even think that
levodopa therapy has the benefit of neuroprotection—protects existing
dopamine producing neurons and possibly slows Parkinson's disease.
Parkinson's Disease Medication Reruns
The new dopamine agonist patch, Neupro showed beneficial results for people
in late-stage Parkinson's disease in a recent study.  So, Neupro may be
effective for people with early Parkinson's disease, as well as in the later
years of the illness.  A few of the medications used to treat people with
Parkinson's are effective at different phases.  Don't be surprised if your
doctor prescribes a medication you used a few years before.  Also, it is
common for people to be using many of these different medications at once.

Sources:

The Parkinson's Disease Foundation
Movement Disorders
Novartis

Rayilyn Brown
Board Member AZNPF
Arizona Chapter National Parkinson's Foundation
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