http://www.parkinsonresearchfoundati...d=780&Itemid=1
Ten Years Follow-up: Levodopa or Ropinirole?
Written by Catherine O'Neill
Tuesday, 11 March 2008
Researchers and clinicians argue about the optimal treatment for patients with early Parkinson’s disease. They worry that premature treatment with levodopa alone will set patients back, provoking early motor complications and dyskinesias when other medications, not containing dopamine may avoid such difficulties. Several studies comparing dopamine agonists with initial levodopa therapy reported a lower incidence of motor complications and less dyskinesia when the two medications were used in tandem. The overall benefit, as evidenced by quality of life standards, UPDRS (Unified Parkinson Disease Rating Scale) scores and activities of daily living scores were generally comparable. Reduced motor disability however, was greater in patients treated with levodopa alone. However, the incidence and severity of motor complications evident in four to five years may be too short a time span to accurately assess potential long- term benefits of early treatment with a dopamine agonist, compared to levodopa.