No Harm in Using Levodopa Early in Parkinson's for Symptom Relief, but the Drug Does Not Provide a Disease-Modifying Effect, Study Finds

[Cagey84]

journals.lww.com/neurotoday...

[Hil101]

The trial ends at 80 weeks. This is before most people start exhibiting the long-term side effects of levodopa such as dyskinesia and 'off' periods. To me, the 'harm' comes later and so the title of this piece misleads. How interesting it would be to see those graphs continued up to 6 years.

[condor39]

This study is very important, and should be required reading for all members of this site.

Too many miss out on the most effective medication for PD duse to a fear of “side effects”. All drugs have side effects, what is important is the “Risk / benefit ratio”.

To extrapolate, drinking to the store has side effects, you might get killed on the highway, but youaccept this risk, for the benefit of getting to the store.

Missing out, or delaying the benefits of L Dopa is misguided

[condor39 in reply to condor39]

Sorry that should have read “Driving to the store”

[Grumpy77 in reply to condor39]

No

Read @Hil101's reply on how the test/trial length is too short to make a conclusion of no side effects

I agree more with his/her post

[PDGal4]

I agree with condor39. Some people need levodopa to function. I can’t speak for those who are tremor dominant. My major symptoms are I am slow and can not maintain repetitive motion. Without medication, I could not exercise. Even walking becomes arduous. On meds, I walk 2 miles a couple times a week, do yoga 5 times a week, and otherwise stay active.

I spent my entire life avoiding medication, taking it only when medically and direfully necessary. When I was diagnosed 7 years ago, it was with much angst, reluctance, and soul searching that I agreed to (several months later) try it. I do have some dyskinesia, which is bothersome, and off periods. I have managed to lower my dosage some, but it’s always a balance of bothersome vs. function.

[Cagey84]

I agree it would have been better to monitor for longer, and to include people with tremor. However to reach a conclusion that there is no difference in dyskinesia whether started early or late means the incidence of motor complications in both groups must have been sufficiently high to evaluate.

This study fits with what appears now to be the accepted position - there is no reason to delay treatment with levodopa if quality of life needs it. See also this from MJFF - michaeljfox.org/foundation/...