When should medication doses change for Parkinson's disease patients?

Some believe more potent drugs used for treatment should not be used for a younger Parkinson's patient, explains Melissa Houser, MD, a neurologist at Scripps Health.

Transcript

00:00

So we usually start on the lower-potency drugs first. But as the patient progresses, if they get to a point,

00:07

depending on their individual situation, where they can't work, they can't hold their grandchildren, then we add the levodopa.

00:13

But we usually don't use it in high doses till we actually need to.

00:25

I personally use what we call levodopa sparing strategy in the young patients because they have a long time

00:33

to live with the disease. That said, the levodopa is really the most potent drug that increases quality of life.

00:40

So we usually start on the lower-potency drugs first. But as the patient progresses, if they get to a point,

00:47

depending on their individual situation, where they can't work, they can't hold their grandchildren, they can't achieve activities of daily living without, you know,

00:56

80% slowness, then we add the levodopa. But we usually don't use it in high doses till we actually need to.

01:05

And there's also a role for the deep brain stimulation, that when you're getting to that mid-stage patient with-- who's developing those complications

01:13

from the levodopa, that's when we use the electrical brain pacemaker, which allows us to back up and sometimes reduce

01:21

medication by 25%, 30%. I've had a few patients go off of the medication altogether. [AUDIO LOGO]