Effect of late initiation of levodopa treatment in patients with long-standing Parkinson's disease.
The time of initiation of levodopa therapy in patients with Parkinson's disease (PD) is still debatable, as is the hypothesis of levodopa toxicity Some researchers argue that late initiation of treatment will delay the appearance of response fluctuations. In the present study, 11 patients in whom treatment with low doses of levodopa was delayed for a mean of 7.9 +/- 3.1 years were followed for a mean of 15.7 +/- 3.3 years. Time of onset of response fluctuations and disease severity were compared with those in 17 patients with fluctuating PD who were treated with levodopa from disease onset. There was no significant change in time to onset of response fluctuations and dyskinesias once levodopa treatment was started, and late initiation of levodopa did not affect disease progression. The authors conclude that the decision of when to initiate levodopa treatment should be taken according to the patient's needs.
Djaldetti
Ruth
R
Department of Neurology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel. yhaimi@bezeqint.net
Treves
Therese A
TA
Merims
Doron
D
Sroka
Hava
H
Melamed
Eldad
E
D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D013997:Time Factors
D000978:Antiparkinson Agents; D007980:Levodopa