New Treatment Guidelines for Parkinson's Patients

Leading neurologists say a change in drug treatment for Parkinson's patients could reduce uncontrollable body tremors for many in the early stages of the disease.

Previous Parkinson's treatment guidelines suggested doctors begin with a drug called levodopa. But that drug actually caused uncontrollable body tremors in many patients. New guidelines released Monday, and featured in the journal Neurology, say doctors should recommend dopamine agonists as a first-line therapy for early stage Parkinson's disease.

This type of treatment is designed to lower the risk of patients developing dyskinesia, the severe uncontrollable jerky body tremors that Parkinson's patients often suffer.

Dr. C. Warren Olanow, one of the authors of the new Parkinson's treatment guidelines tells ABCNEWS' Good Morning America that patients given dopamine agonists experienced significantly fewer motor complications than those getting levodopa, in recent studies.

"Eighty percent of people who take levodopa have complications from the drug — involuntarily movements and fluctuating responses," says Olanow, the chairman of neurology department at the Mt. Sinai School of Medicine.

"A number of studies have now shown that if you start with a new class of drug called dopamine agonists, it last longer and reduces dramatically the chances that you will develop motor complications," says Olanow.

Agonists available in the United States include bromocriptine (Parlodel), pergolide (Permax), pramipexole (Mirapex) andropinirole (Requip).

Nearly 1 Million Americans Affected

Parkinson's disease, a disorder of the central nervous system that impacts between 800,000 and 1 million Americans, affects movement, muscle control, and balance. It is characterized by shaking and difficulty with walking and coordination.

The new guidelines for treating Parkinson's are a departure from those that were published in 1998 in the journal Neurology, which suggested that either a dopamine agonist or levodopa could be used early on. Doctors decided to make the switch after a series of double blind studies that advanced research on how to treat Parkinson's disease.

The new studies found that as many as four out of five new Parkinson's patients who took levodopa, a drug that has been used for 30 years, developed major motor problems.

The guidelines call for adding levodopa to treatment as the disease progresses, and when the dopamine agonists have ceased to keep the disease under control. Levodopa is sold under the name Sinemet and also is available in a generic form.

Olanow also believes there are some great new treatments for Parkinson's disease on the horizon.

"Not only are there treatments to reduce the risks of motor complications, but there are more surgical measures that can reverse it," he says. "In the long run, the ultimate hope is to develop a cure for the disease and the prospects for that are better than ever.

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