Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Appropriate treatment for a patient with a recent diagnosis of Parkinson's disease:
- Offer levodopa to patients in the early stages whose motor symptoms impact their quality of life.
- For those whose motor symptoms do not impact quality of life, consider dopamine agonists, levodopa, or monoamine oxidase-B (MAO-B) inhibitors as treatment options.
- Do not use ergot-derived dopamine agonists as first-line treatment due to safety concerns.
- Before starting treatment, discuss with the patient their individual clinical and lifestyle circumstances, preferences, and the potential benefits and harms of each drug class.
- Provide oral and written information to patients and their carers about risks associated with dopaminergic therapies, including impulse control disorders, excessive sleepiness, and psychotic symptoms.
- Avoid abrupt withdrawal of antiparkinsonian medicines to prevent acute akinesia or neuroleptic malignant syndrome.
- Refer patients early to allied health professionals such as occupational therapists and speech and language therapists for assessment and support.
- Advise patients on nutrition, including protein redistribution diets if on levodopa and vitamin D supplementation.
These recommendations aim to tailor treatment to individual needs while minimizing risks and optimizing quality of life.
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