title: [Initiation of treatment in Parkinson disease].
abstract: Initiating treatment in a patient with Parkinson's disease requires consideration of age, degree of disease activity, and consequences of long-term treatment. In young patients, albeit dopaminergic agonists or selegiline are possible alternatives, they will never be as effective as L-dopa, and they can be used only initially in very mild cases and for a short period of time. Long-acting L-dopa is probably better after titration with standard preparations. Potential neuroprotection by selegiline has not been confirmed so far, but it acts as a mild anti-Parkinsonian. In patients over 60, it is recommended not to use anticholinergic or dopaminergic agonists, but to start with a low dose of L-dopa and increase it by a maximum of 125 mg every 7 to 10 days. Clozapine can be very useful against psychosis.
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000547:Amantadine / Q000627:therapeutic use; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D018491:Dopamine Agonists / Q000627:therapeutic use; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D012642:Selegiline / Q000627:therapeutic use
chemical_list: D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D012642:Selegiline; D007980:Levodopa; D000547:Amantadine
vernacular_title: L'initiation du traitement dans la maladie de Parkinson.