A CASE AGAINST EARLY LEVODOPA TREATMENT OF PARKINSONS-DISEASE

Much has been written concerning whether to begin levodopa treatment early or late in patients with Parkinson's disease (PD), and the debate will probably continue for many years. In this article I shall present my personal perspective on this issue. In older patients I can see little cause to delay levodopa therapy. However, I submit that the shorter latency to develop more frequent and severe fluctuations and, particularly, dyskinesias in patients with young-onset PD argues in favor of delaying levodopa therapy, provided that in the interim the symptoms and signs of the disease can be adequately managed using other therapies.