Early Parkinson Disease
Key Points
Key Points
- The treatment options for the alleviation of motor symptoms in the early stages of Parkinson disease (PD) are based on the enhancement of dopaminergic tone with levodopa, monoamine oxidase inhibitors, dopamine agonists (DAs), or a combination thereof.
- The choice of initial treatment is influenced by the potential for neuropsychiatric adverse effects associated with DAs and dyskinesia and motor fluctuations associated with levodopa.
Treatment
Treatmen...
...vs. DAs vs. MAO-B inhibitors...
...linicians should counsel patients wit...
...h early PD who seek treatment for mo...
...may prescribe DAs as the initial dopamin...
...hould not prescribe DAs to patients with early-sta...
...rescribing levodop...
...nicians should initially prescribe immedia...
In patients with early PD, clinicians sho...
...cians should routinely monitor patients taking le...
...nicians should counsel patients taking levod...
...nicians should counsel patients that in later...
...ribing DAs...
...cians should inform the patient and caregiver (whe...
...hould screen patients for cognitive impair...
...ould screen patients for the presence of adverse e...
...s should involve caregivers in assessments f...
...ans may screen patients for the presenc...
...ans should integrate patient preferences...
...should prescribe the lowest dose of DA required...
...apering and Discontinuing DAs
...ns should recommend tapering or disco...
...e discontinued due to adverse effects,...
...cribing MAO-B inhibitors
...d counsel patients with early PD on the greater...
...inicians may prescribe MAO-B inhibitors as the i...
...or Parkinson DiseaseHaving trouble viewi...