Skip to content
My WebMD Sign In, Sign Up

Parkinson's Disease Health Center

Font Size

Parkinson's Disease: Levodopa Versus Dopamine Agonists - Topic Overview

No known treatment can stop or reverse the breakdown of nerve cells that causes Parkinson's disease. But medicine can relieve many symptoms of the disease.

Treatment is different for every person. And the type of treatment you will need may change as the disease progresses. Your age, work status, family, and living situation can all affect decisions about when to begin treatment, what types of treatment to use, and when to make changes in treatment. As your medical condition changes, you may need regular adjustments in your treatment to balance quality-of-life issues, side effects of treatment, and treatment costs.

Recommended Related to Parkinson's

Understanding Parkinson's Disease -- the Basics

Parkinson's disease, which mostly affects older people but can even occur in younger adults, results from the gradual degeneration of nerve cells in the portion of the midbrain that controls body movements. The first signs are likely to be barely noticeable -- a feeling of weakness or stiffness in one limb, or a fine trembling of one hand when it is at rest. Eventually, the shaking (tremor) worsens and spreads, muscles become stiffer, movements slow down, and balance and coordination deteriorate...

Read the Understanding Parkinson's Disease -- the Basics article > >

The decision to start taking medicine, and which medicine to take, will be different for each person with Parkinson's disease. Your doctor will be able to help you make these choices.

For many years, levodopa has been the drug of choice for treating Parkinson's disease. Although many newer drugs have been developed, including the dopamine agonists (for example, pramipexole), levodopa is still considered the most effective drug for relieving the widest range of symptoms. It helps reduce tremor, stiffness, and slowness. And it helps improve muscle control, balance, and walking.

When dopamine agonists are used alone, they are helpful in relieving most symptoms of early Parkinson's disease, especially those that affect motor function (such as stiffness and slowness). They are not as effective as levodopa in controlling tremor and other symptoms. And they tend to have more side effects than levodopa.

Because levodopa controls the symptoms of Parkinson's disease so well—and with so few side effects at the beginning—there is some benefit for people who start treatment with levodopa, rather than with a dopamine agonist. A person with Parkinson's disease who starts treatment with levodopa may have more early years with better control of symptoms and fewer side effects.

But it also is well documented that most people who take levodopa develop motor problems (motor fluctuations) within 5 to 10 years after starting the medicine. These complications—unpredictable swings in motor control between doses and uncontrollable jerking or twitching (dyskinesias)—can be hard to manage and can become as disabling as some of the problems caused by the disease itself. But in the longest study done, people who started treatment with a dopamine agonist had just as many problems with motor fluctuations at 14 years as people who started treatment with levodopa.1

In an effort to delay the development of motor fluctuations, many doctors are now starting people with early Parkinson's disease on a dopamine agonist rather than levodopa. A dopamine agonist may be used until it no longer adequately relieves symptoms, at which point the person starts taking levodopa in addition to the dopamine agonist. (Dopamine agonists can also cause severe sleep problems and hallucinations in some people. Having these side effects may be another reason to switch to levodopa.) As long as the person's symptoms are adequately controlled and he or she can tolerate the drug, dopamine agonists may be a good choice for treating early Parkinson's disease.

1|2

WebMD Medical Reference from Healthwise

Last Updated: December 05, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
Next Article:

Parkinson's Disease: Levodopa Versus Dopamine Agonists Topics

Today on WebMD

Parkinsons disease illustration
Slideshow
Parkinsons Disease Symptoms
Article
 
Preventing Falls
Article
caregiver
Article
 
Parkinsons Disease Medications
Article
Questions Doctor Parkinsons
Article
 
Eating Right
Article
Parkinsons Exercise
Article
 
daughter consoling depressed mother
Article
senior man's hands
Article
 
Parkinsons Daily
Article
Acupunture
Article
 

WebMD Special Sections