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- Title
INITIATING TREATMENT IN EARLY PARKINSON'S DISEASE.
- Authors
Tarsy, Daniel
- Abstract
Many factors affect the decision to initiate pharmacotherapy for Parkinson's disease (PD), and it is a joint decision among the patient, the physician, and the patient's family. Drug treatment for PD should be individualized for the particular patient. If a medication switch is considered, the decision to switch medication has to be weighed carefully, because the number of treatment options is limited. Almost all of the PD drugs require titration. At each dose level, a decision must be made whether to continue increasing the dose (and risk adverse events, which are commonly dose dependent) or to live with the current treatment effect. Each decision is a tradeoff for the patient. When assessing treatment outcomes, as with diagnosis, the history and examination are critical, as are discussions with the patient and family about expectations before treatment is started. This article reviews factors affecting the decision for treatment initiation, how to assess treatment response, and determining when to switch medications. The article also includes extracts from an interview with one of my patients, who describes the diagnostic process from his point of view.
- Subjects
PARKINSON'S disease treatment; BRAIN disease treatment; EXTRAPYRAMIDAL disorders; DRUG therapy; MEDICAL care; THERAPEUTICS
- Publication
Johns Hopkins Advanced Studies in Medicine, 2008, Vol 8, Issue 12, p419
- ISSN
1530-3004
- Publication type
Article