For a newly diagnosed patient with Parkinson's disease, consider discussing the person's individual clinical circumstances, lifestyle, and preferences before starting treatment, including the potential benefits and harms of different drug classes NICE CKS.
Offer levodopa to people in the early stages of Parkinson's disease whose motor symptoms impact on their quality of life NICE CKS.
Alternatively, consider a choice of dopamine agonists or monoamine oxidase‑B (MAO‑B) inhibitors for those whose motor symptoms do not impact their quality of life NICE CKS.
Do not offer ergot-derived dopamine agonists as first-line treatment NICE CKS.
When initiating treatment, provide oral and written information about risks such as impulse control disorders, excessive sleepiness, psychotic symptoms, and the importance of medication adherence NICE CKS.
Ensure ongoing review and specialist involvement, especially if motor symptoms or complications persist or are troublesome, and consider specialist management for motor fluctuations or dyskinesia NICE CKS.