Originally Posted by RLSmi

Recognizing that my whole situation is not easily comparable to yours:
1. I was 63 when diagnosed, and from day 1 was prescribed sinemet by my neurologist to alleviate PD symptoms. At that time he also gave me the option of trying one of the dopamine analogs, but I chose to stay with sinemet because of its effectiveness in releiving both the motor and depressive symptoms I was dealing with.
2. I am being followed in an academic medical center by the head of the neurology department, who is very tolerant, even supportive of my experimental approaches to PD treatment.

Although the approach to initiating treatment in younger patients often emphasizes starting with agonists like Mirapex or Requip, the reason for this, that they may have neuroprotective effects Sinemet does not have, is not supported by current data. The goal of avoiding Sinemet as long as possible to stave off its eventual production of dyskinetic side effects may also be less valid than previously thought. If Sinemet treatment is carefully managed, some patients have successfully taken it for 10-20 years without developing significant diskinesia.