What are the current guidelines for the pharmacological management of patients with newly diagnosed Parkinson's disease?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Offer levodopa to people in the early stages of Parkinson's disease whose motor symptoms impact on their quality of life.

Consider a choice of dopamine agonists, levodopa or monoamine oxidase B (MAO‑B) inhibitors for people in the early stages of Parkinson's disease whose motor symptoms do not impact on their quality of life.

Do not offer ergot-derived dopamine agonists as first-line treatment for Parkinson's disease.

When starting treatment, discuss with the person their individual clinical circumstances, lifestyle, preferences, and the potential benefits and harms of the different drug classes.

Antiparkinsonian medicines should not be withdrawn abruptly to avoid risks such as acute akinesia or neuroleptic malignant syndrome.

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