Interesting question. I was diagnosed in April of this year at the age of 46. Rigidity, lack of arm swing on my right side, micrographia, loss of motor skills in my right hand (I'm right handed), some dystonia between my shoulder blades and into the base of my neck, bradykinesia, and slight tremor in my right hand. I consider myself very early on in the disease and my UPDRS rating was a 17, indicating "mild" PD, although to me it feels more than mild a lot of the time!
I was originally offered Mirapex to start on but declined due to all the horror stories I was hearing about OCD behaviors. I naturally have OCD, so it scared me. I elected to start on Sinemet, 25/100 3X a day and I feel better than I have in 6 or more years. I guess some people call this the honeymoon period.
Recently, the MDS who did the UPDRS on me suggested that I try Requip in combination with the Sinemet so I could cut back on the Sinemet, but I haven't made that decision yet. Still a bit scared of the OCD aggravation potential. I'm well aware I may need the agonist at some point in my treatment but I don't know if I'm ready for it right now.
I've heard lots of arguments justifying starting with Sinemet, not starting with Sinemet, dopamine agonists, holding off on any meds until you feel you really need it, etc. The problem is, most of the arguments have two basic faults to them. One, they seem to be based on purely anecdotal evidence, not scientific. And two, everyone truly is different in terms of how the disease affects them. Our biological makeup is so different from one another. What works for one person doesn't mean it will work for me or you. PD truly is a designer disease.
So in a sense, you have to hear the stories and make the choice that fits you best. And that's truly a tough thing to do. The way I see it, I could second guess myself to death. But life is short, so I'll just make a decision that I feel is right for me and move forward the best I can.
I guess I've chosen quality over quantity and I'm okay with that.
Todd
PDTalks.com