Early treatment: levodopa vs. MAOI

Hi all. Was wondering if anyone could offer data/opinions/experience on whether to start Levodopa vs. MAOI treatment (rasagiline) for a friend (52 years old) just diagnosed. Symptoms are mild but interfere a bit with daily living: lack of dexterity in dominant hand, apathy. I've read The Lancet's PD MED study from 2014 but am wondering what the longer-term implications of starting Levodopa now would be. Any input much appreciated!

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  • I was diagnosed at 46 which was 14 yrs. ago. I started out on Aziilect (rasagiline) and also took Requip. The combination worked good for about 6 years but my symptoms were gradually getting worse and my neuro said if I wanted to still work, I needed to start C/L, so I did. I had to go off Requip because I had breast cancer and had to take Tamoxifen for 5 yrs. and the 2 didn't mix. The C/L worked good. I was able to work another 4 yrs. but then the stress from work was making my symptoms worse so I decided to retire. I've been retired for 3 years. Knock on wood, the only side effect with the C/L is a little bit of Dyskensia, but I take Amantadine for that so it's not that bad. "They" once said Azilect is neuro-protective, but now they are not sure. C/L really helps your movement, therefore; I'm able to move better and exercise more. And, I believe exercise helps a lot in delaying the symptoms of PD. "They" also say C/L will not work as well after a few years. I've been on C/L for 8 years and it's still quite effective. I take 4 C/L's a day 25/100. I try to keep it to a minimum. Not sure how much longer it will help, but so far ok. You'll get a lot of different opinions on this subject. If you want to improve your movement, I would say go ahead and take C/L but keep it to a minimum or you can try and take MP and exercise first. (not sure why this print is changing at times?) Good luck!

  • I am in UK. On diagnosis my neurologist prescribed Azilect (rasagiline). I felt better for it, and it was my only PD medication for three years. When walking became more difficult I was prescribed a low dose of Siminet in addition to Azilect.

    Your friend should see a neurologist who specialises in PD/ movement disorders. Also a Neuro physio who can advise about 'neuro protective' exercises.

  • MAO inhibitors never did anything for me. Levodopa works.

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