Dear Emma,
Some neurologists tend to delay the use of levodopa in the
early stage of Parkinson's disease (PD). Although levodopa (Sinemet,
Madopar, Prolopa) gives the best results for most of the Parkinson symptoms, the
early use may give side effects at an earlier time, such as uncontrollable
movements and fluctuations of the response to levodopa. I prefer to give
low dosages of levodopa in combination with an dopamine agonist (bromocriptin,
pergolide, ropinorol or pramipexole), because the addition of levodopa just
makes a beneficial difference, that is most symptoms further improve with
respect to disability or an annoying tremor.
Efexor is an anti-depressant drug, which may benefit a
Parkinson patient if depression is one of the dominant feautures.
Sincerely,
Chris van der Linden, M.D.
St. Lucas Hospital Ghent
BELGIUM
