Should a Person Start Dopamine Right Away?
When to start dopamine replacement therapy is one of the biggest
controversies within Parkinson's disease, and physicians tend to have
different opinions on the issue. Many patients and physicians opt to
delay using Sinemet, Parcopa, and other levodopa therapies until
symptoms are more pronounced. Levodopa loses its effectiveness over
time, so some people prefer to preserve that effectiveness to later
in the disease when they will need it more. Some physicians will
start their patients on a dopamine agonist, MAO-B inhibitor or an
anticholergenic for use in the early stages.

There are more than a dozen anti-Parkinson's medications that address
the shortage of dopamine central to Parkinson's disease. Your
physician will match medications to your particular needs. There
are some medications that tend to be most useful at certain stages in
Parkinson's disease. The following graphic outlines some approximate
seasons within Parkinson's disease when patients tend to start
certain anti-Parkinson's medications and use them the most. It is
intended for general information only. Many physicians will
introduce medications at times other than indicated on the chart.



Some data indicates that people who start Levodopa early do better
with Parkinson's disease for a longer period of time. Some even
think that levodopa therapy has the benefit of neuroprotection—
protects existing dopamine producing neurons and possibly slows
Parkinson's disease.

Parkinson's Disease Medication Reruns
The new dopamine agonist patch, Neupro showed beneficial results for
people in late-stage Parkinson's disease in a recent study. So,
Neupro may be effective for people with early Parkinson's disease,
as well as in the later years of the illness. A few of the
medications used to treat people with Parkinson's are effective at
different phases. Don't be surprised if your doctor prescribes a
medication you used a few years before. Also, it is common for
people to be using many of these different medications at once.

Sources:

The Parkinson's Disease Foundation