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