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Subject: When to start PD Medicines To: Cindy Birk Conley Hello Cindy, I think you will find that the opinion among the majority of neurologists these days is that the timing of the introduction of Levadopa (which is by far the most important drug in overcoming the symptoms of PD), does not influence the duration of effectiveness, or the build-up of tolerance. The view expressed by your doctor is ,I think, governed by the observation that later on it becomes more and more difficult to find a dosage regime for Levadopa( Usually the drug Sinemet) which is effective and without side effects. The probability however is that this increased sensitivity is caused by the continuing progress of Parkinson's Disease, which always gets worse, never gets better, and would have got there with or without the use of Levodopa. There is a warning however: Some doctors go a bit overboard with this strategy, and prescribe large doses such as the 250mg version of Sinemet. Your mother will probably be able to take even that high quantity in her present state, but later on there could be trouble. The message is: Only take enough to do the job, and creep up to that minimum level slowly and carefully. In fact that is good advice to apply to all Parkinson's Drugs; they are powerfull drugs and should be treated with care. But for the improvement that they provide, it is worth the effort. Regards, Brian Collins.