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Levodopa comes up trumps for long-term Parkinson's treatment

Levodopa comes up trumps for long-term Parkinson's treatment
12th June 2014

The largest trial of Parkinson's disease treatments has shown that levodopa is the most effective drug in the long term.

Levodopa is the most commonly used drug for those with the neurological condition and this trial proved that such individuals enjoy an enhanced quality of life while using this treatment method, in comparison to newer drugs, like dopamine agonists (DA) and monoamine oxidase type B inhibitors (MAOBI). 

Some individuals can develop involuntary muscle spasms and motor fluctuations after they've been using levodopa for a considerable length of time. While DA and MAOBI have a reduced chance of bringing about these adverse symptoms, other side effects can develop, including nausea, hallucinations, oedema and sleep disturbance.

More than 1,600 patients with early forms of Parkinson's disease were either given levodopa or one of the newer drugs. 

After up to seven years of follow-up, both mobility and quality life were improved when using levodopa as opposed to others. 

In addition to this, those on levodopa recorded noticeably better scores when rated on daily living, stigma, cognition, communication and bodily discomfort scales. This was in spite of the fact some experienced involuntary muscle spasms. 

Professor Richard Gray from the University of Oxford said: "Previous studies included too few patients, had short follow-up and focused on the clinicians' assessments of motor symptoms rather than asking patients how the drugs affected their overall quality of life.

"So, for many years there has been uncertainty about the risks and benefits of starting treatment with these different classes of Parkinson's drugs."

While he conceded the differences in favour of levodopa were small, taking everything into consideration - such as benefits, side-effects and costs - this drug was still the "best initial treatment strategy for most patients". 

Clinical coordinator of the study from the University of Birmingham Professor Carl Clarke said the findings of this research, which can be viewed in the Lancet, were likely to change clinical practice across the globe. 

Parkinson's disease is the second most common neurological disorder after Alzheimer's. There is thought to be around 127,000 people living with it in the UK, with approximately 8,000 new cases every year.

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