The End of Levodopa Phobia?

An important update for clinicians treating patients with Parkinson disease

Which medication should be used as first-line therapy for Parkinson disease (PD) has been an open and important question. To address this question, researchers conducted a pragmatic, open-label, randomized trial in patients with a new diagnosis of PD. The 1620 patients were randomized to receive a dopamine agonist (632 patients), a monoamine oxidase inhibitor (MAOBI; 460 patients), or levodopa (528 patients). Both patients and clinicians were aware of their treatment status. The primary outcome was the mobility dimension on the Parkinson's disease questionnaire (PDQ-39) quality-of-life scale.

Median follow-up was 3 years. The average PDQ-39 mobility score over the first 7 years was 1.8 points better with levodopa than with the other two trea…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)