Fast Five Quiz: Management of Parkinson's Disease

Rajesh Pahwa, MD


January 13, 2022

Most patients taking dopamine agonists as monotherapy and MAO-B inhibitors will generally need complementary therapy within 2-3 years compared with those treated with levodopa and or dopamine agonists. Still, dopamine agonists may be prescribed for patients with mild motor symptoms early in the disease course.

In advanced Parkinson's disease, taking levodopa with meals may decrease therapeutic efficacy.

Dopamine agonists should not be prescribed to patients with early-stage Parkinson's disease who are at higher risk for medication-related adverse effects, excluding dyskinesia. Such patients may include those over 70 years of age, or patients with a history of impulse control disorders, cognitive impairment, excessive daytime sleepiness, or hallucinations. Dopamine agonists may be considered as an initial dopaminergic therapy for certain patients under 60 who are at higher risk for dyskinesia.

Compared with levodopa, use of dopamine agonists is associated with an increased risk for impulse control disorders, excessive daytime sleepiness, sudden-onset sleep, nausea, and hallucinations.

Learn more about therapy for symptoms of early disease.


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