[Are dopamine agonists alternative therapy for levodopa in early stage of Parkinson's disease? No].
There is a long lasting discussion in the literature how should we begin the treatment of Parkinson's disease. The author presents the arguments, why the treatment should not be started with agonists of dopamine receptors but with levodopa. The clinical efficacy of levodopa is certainly much higher than that of agonists. It is probably related to the fact that levodopa leads to the production of natural neurotransmitter in the striatum - the dopamine. Even the best artificial agonist cannot fully mimic the function of dopamine. And there are no doubts that levodopa does not hasten the parkinsonian neurodegeneration. Starting the treatment with an agonist one does not achieve as good results as with levodopa, and later when the addition of levodopa becomes a necessity, there is already such a destruction of substantia nigra that the effect is unsatisfactory for patients. Therefore the treatment of Parkinson's disease should be started with levodopa.
Friedman
Andrzej
A
Katedra i Klinika Neurologii Wydziału Nauki o Zdrowiu, Akademia Medyczna w Warszawie. friedman@amwaw.edu.pl
D000978:Antiparkinson Agents / Q000494:pharmacology* / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007980:Levodopa / Q000494:pharmacology* / Q000627:therapeutic use; D010300:Parkinson Disease / Q000188:drug therapy; D012720:Severity of Illness Index
D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D007980:Levodopa