Study backs drug choice for Parkinson's

octors now have an alternative in how they treat patients newly diagnosed with Parkinson's disease, according to a study in a recent issue of the Journal of the American Medical Association. Besides levodopa, which for three decades has been the standard treatment for almost all new patients, the study found that doctors should also consider another type of drug known as a dopamine agonist.

"For 30 years the initial treatment of this disease has been straightforward," said Ira Shoulson, the Rochester neurologist who heads the Parkinson's Study Group, which conducted the study and is led by physicians at the Medical Center. "Now, there is a real choice that doctors and patients should be discussing."

Parkinson's patients have long faced a dilemma: Effective treatment of the disease eventually causes complications so severe that they can be worse than the disease itself. In this study of 301 patients at 22 study sites around the United States and Canada, doctors discovered that pramipexole, a medication known as a dopamine agonist, can offer a trade-off between side effects and treatment effectiveness that physicians and patients should consider.

While the findings about the effectiveness of the medications are mixed, the bottom line is that patients and their doctors now have a choice of treatments that will depend on a patient's individual circumstances, said lead author Robert Holloway, a neurologist at Rochester and first author of the study.

"Up to this time, levodopa has been the mainstay of therapy for Parkinson's patients," Holloway said. "We now have strong evidence that there are viable alternatives. We have options that will allow patients and families to make more informed decisions about what treatments are best for them."

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