The treatment of early Parkinson's disease: levodopa rehabilitated
Identifieur interne : 001A82 ( Main/Corpus ); précédent : 001A81; suivant : 001A83The treatment of early Parkinson's disease: levodopa rehabilitated
Auteurs : Annemarie Vlaar ; Ad Hovestadt ; Teus Van Laar ; Bastiaan R. BloemSource :
- Practical Neurology [ 1474-7758 ] ; 2011-06.
Abstract
Many clinicians regard levodopa as a last resort in the symptomatic treatment of Parkinson's disease. Here we critically review the arguments that are typically used to postpone the start of levodopa for as long as possible. We will point out that most concerns are invalid. Levodopa remains the most effective and best tolerated Parkinson's drug to date, and should have an important role in all therapeutic strategies, both as monotherapy in early Parkinson's disease and as part of combination therapy in advanced disease. Regardless of disease stage, the choice of a particular drug should not be driven by fear of long term complications but by the clinical condition of the patient at the time, with an emphasis on functioning in everyday life and any comorbidity. A ‘phobia’ for levodopa—or, indeed, for any other antiparkinsonian medication—is unacceptable according to current evidence.
Url:
DOI: 10.1136/practneurol-2011-000011
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For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2011</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="practneurol-11-145.pdf"></self-uri><abstract><p>Many clinicians regard levodopa as a last resort in the symptomatic treatment of Parkinson's disease. Here we critically review the arguments that are typically used to postpone the start of levodopa for as long as possible. We will point out that most concerns are invalid. Levodopa remains the most effective and best tolerated Parkinson's drug to date, and should have an important role in all therapeutic strategies, both as monotherapy in early Parkinson's disease and as part of combination therapy in advanced disease. Regardless of disease stage, the choice of a particular drug should not be driven by fear of long term complications but by the clinical condition of the patient at the time, with an emphasis on functioning in everyday life and any comorbidity. A ‘phobia’ for levodopa—or, indeed, for any other antiparkinsonian medication—is unacceptable according to current evidence.</p></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>The treatment of early Parkinson's disease: levodopa rehabilitated</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>The treatment of early Parkinson's disease: levodopa rehabilitated</title></titleInfo><name type="personal"><namePart type="given">Annemarie</namePart><namePart type="family">Vlaar</namePart><affiliation>Department of Neurology, Donders Institute for Brain Cognition and Behaviour, Nijmegen Medical Centre, Radboud University, Nijmegen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ad</namePart><namePart type="family">Hovestadt</namePart><affiliation>Department of Neurology, Meander Medisch Centrum, Amersfoort, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Teus</namePart><namePart type="family">van Laar</namePart><affiliation>Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bastiaan R</namePart><namePart type="family">Bloem</namePart><affiliation>Neurologist, Department of Neurology, Donders Institute for Brain Cognition and Behaviour, Nijmegen Medical Centre, Radboud University, Nijmegen, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="review-article"></genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2011-06</dateIssued><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Many clinicians regard levodopa as a last resort in the symptomatic treatment of Parkinson's disease. 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