First Line Meds and Dosing

In general it is recommended that you start with a dopamine agonist< if your patient is younger than 50 years; you should consider starting with carbidopa/levodopa< if your patient is older than 70 years; either option is good if your patient is between 50 and 70 years old. Usually, younger patients tolerate dopamine agonists better than older patients but both are potential options.
Many experts will start carbidopa/levodopa rather than a dopamine agonist if there are balance, walking, or cognitive isuues.
There is controversy around delaying the initiation of pharmacotherapy<.

The central objective of using Parkinson’s disease medication is to control or manage motor symptoms. Since these symptoms are largely due to the diminishing supply of dopamine in the brain, most symptomatic medication are designed to replenish, mimic, or enhance the effect of this chemical. Remember that medication usage is only a part of the whole treatment plan for effectively treating PD.

These are the most commonly used medications in PD: