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Charles H. Markham, MD; Shirley G. Diamond

Arch Neurol. 1986;43(4):405-407.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Levodopa treatment is unquestionably the reason parkinsonian patients now live a normal¹ or nearnormal² life span. When in the course of the disease levodopa therapy should begin remains controversial for several reasons: the initial favorable response to the drug is followed by a gradual decline; the impression that levodopa has a finite period of optimal usefulness³; and the assumption that severe dyskinesia and a true "on-off" effect are related to duration of treatment. These suggestions have led some to believe that levodopa should be held in reserve until the patient is at least moderately afflicted, so that it is not "wasted" on early stages of the disease.

Our data lead us to conclude that this reasoning is fallacious. When the condition of a patient with a progressive disease who is receiving long-term drug treatment is seen to worsen over time, two possibilities arise. The first is that . . . [Full Text PDF of this Article]

Author Affiliations
From the UCLA School of Medicine, Reed Neurological Research Center.

Footnotes
Accepted for publication May 10, 1985.

Reprint requests to UCLA School of Medicine, Reed Neurological Research Center, Los Angeles, CA 90024 (Dr Markham).

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