Parkinson's Disease: Levodopa Versus Dopamine Agonists - Topic Overview
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.
This approach is being used particularly in younger people with Parkinson's disease, because it can delay the need for levodopa and thus may postpone the motor fluctuations that occur with long-term levodopa therapy. The American Academy of Neurology now recommends this course of treatment for most people with early Parkinson's disease, regardless of their age.
Still, most people with Parkinson's disease eventually need to take levodopa to control their symptoms, even if they initially begin treatment with a dopamine agonist. Levodopa continues to offer the strongest and most immediate relief of Parkinson's symptoms.
As the disease progresses and motor fluctuations become more severe, medicines may be used together. And your doctor may change the amount and type of medicines you are taking.