Is There a Controversy About When to Start Medication for Parkinson's Diesease?

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I've personally used what we call a levodopa-sparing strategy in the young patients because they have a long time to live with the disease that said the levodopa is really the most potent drug that increases quality of life. So we usually start on the lower potency drugs first, but as the patient progresses if they get to a point depenbding on their individual situation where they can't work, they can't hold their grandchildren, they can't achieve it if it's a daily without 80% slowness then we add the liver doppler, but we usually don't use it in high doses till we actually need to.

and then there is also a role for the deep brain stimulation that when you're getting to that mid-stage patient who is developing those complications from the liver doper that's when we use the electrical brain pacemaker which allows us to backup and sometimes reduce medication by 25, 30% I've had a few patients go off of the medication altogether.