looking in from the outside in terms of the levodopa experience, this is how it looks to me.

levodopa is like a miracle for the first X years (could be one year, could be 10, could be more, but it is unlikely) and then its usefulness begins to deteriorate - wearing off, on/off fluctuations, and dyskinesias all set in sooner or later, and the younger one is, the sooner they set in.

at the onset of such side effects, perhaps one's dosage or one's dosing schedule is changed, but eventually, another drug is added, ostensibly to alleviate these side effects. it could be amantadine to alleviate dyskinesias, or comtan to ameliorate wearing off, or perhaps a dopamine agonist or an MAO-B inhibitor. and eventually another drug is added, and potentially even another - all to try and alleviate the side effects of levodopa.

ultimately, one ends up arranging one's life as best one can around a precisely choreographed dosing of a cocktail of drugs, their benefits, their side effects, and of course, symptoms, a system which, unfortunately, rarely works better than adequately, and ever more often falls farther and farther short.

and then one has DBS, the ultimate levodopa adjunct.

how accurate is this perception, in your knowledge/experience?

thank you,
boann