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
Movement Disorders