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The early treatment of Parkinson's disease: levodopa, dopamine agonists or both.
MedLine Citation:
PMID:  11008193     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Much has been written about the pharmacologic management of Parkinson's disease (PD) because of an expanding arsenal of antiparkinson drugs and our quest to alter the natural history of disease. Choice of initial therapy may prove fundamental to a treatment strategy that maximizes symptomatic control while minimizing the chances for long-term complications such as motor fluctuations and dyskinesias. Dopamine agonists (DA) have assumed a primary role in the early therapy of PD because of their antiparkinson effectiveness and low propensity to induce fluctuations and dyskinesias. Four available DA in the United States and an array of recent studies supporting their utility in early PD have shaped current PD management. Moreover, DA have neuroprotective properties in vivo. Nevertheless, levodopa remains the most effective drug for symptomatic control in PD. There is conflicting evidence regarding the putative neurotoxicity of levodopa and the mechanisms for levodopa-related motor fluctuations are not entirely known. Clinicians must therefore weigh the available evidence as they initiate therapy in PD. Clearly, both DA and levodopa will remain essential components of the early management of PD.
Authors:
Stern
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Parkinsonism & related disorders     Volume:  7     ISSN:  1873-5126     ISO Abbreviation:  Parkinsonism Relat. Disord.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-09-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9513583     Medline TA:  Parkinsonism Relat Disord     Country:  -    
Other Details:
Languages:  ENG     Pagination:  27-33     Citation Subset:  -    
Affiliation:
Parkinson's Disease and Movement Disorders Center, University of Pennsylvania, Philadelphia, PA, USA
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