Abstract
The approach to early Parkinson’s disease denotes the communication of the diagnosis and important decisions, such as when and how to start treatment. Evidence based medicine and guidelines indicate which drugs have robust evidence of efficacy and tolerability in this specific population. However, de-novo patients may show different characteristics and they may be in a different phase of their disease.In this review, we will give an insight into the appropriate time therapy should be started and the actual knowledge about disease modification therapies. Moreover, the drugs indicated for early treatment will be considered and an indication for the use of these drugs will be given with the support of the actual knowledge.
Highlights
The approach to early Parkinson’s disease denotes the communication of the diagnosis and important decisions, such as when and how to start treatment
In this review the drugs indicated for early treatment will be considered and an indication for the use of these drugs will be given with the support of the actual knowledge
The possibility that levodopa/carbidopa combined with entacapone (LCE), administered 4 times daily at 3.5 hour intervals, might reduce the risk of dyskinesia compared with levodopa/carbidopa (LC) alone was tested in a prospective, double-blind trial; this included 745 subjects treated for 134–208 weeks [30]
Summary
The approach to early Parkinson’s disease denotes the communication of the diagnosis and important decisions, such as when and how to start treatment. The treatment of patients with early Parkinson’s disease should aim to slow down clinical progression, control motor and non-motor symptoms, maintain functioning in daily-life activities, prevent motor complications and minimize the risk of side effects.
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