Is Levodopa safe for long-term use for Parkinson’s disease?

Question

Hello Doctor,

I am 61 years old and was recently diagnosed with early-stage Parkinson's disease after noticing hand tremors and slower movement. My DaTscan showed that the dopamine activity was reduced on the right side of my brain. My blood tests for thyroid function and vitamin B12 levels were normal, so those possible causes were ruled out.

My doctor suggested starting treatment with Levodopa, but I am concerned about the long-term effects of this medicine. Can you please help me understand what the scan results mean and whether it is better to begin taking the medicine now or wait until my symptoms get worse?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

The scan showed reduced dopamine activity on the right side of the brain, which supports the diagnosis of Parkinson's disease. This kind of imbalance, where one side is more affected than the other, is common in the early stages of the disease. While the scan helps confirm the diagnosis and rules out other conditions such as essential tremor, it does not predict how quickly the disease will progress.

Levodopa is the most effective medication for relieving symptoms of Parkinson’s disease, such as tremors, slow movements, and stiffness. However, using Levodopa for a long time, usually more than five years, can sometimes lead to motor problems, including wearing off between doses and involuntary movements called dyskinesias. Even so, delaying the use of Levodopa also carries risks, such as worsening symptoms that can affect your quality of life and increase the chance of falling.

Deciding whether to start Levodopa now or wait depends on how much the symptoms are interfering with your daily life. If the symptoms are mild and not affecting your routine activities, some doctors may recommend starting with other medications like monoamine oxidase B inhibitors (such as Rasagiline) or dopamine agonists (such as Pramipexole) to delay the need for Levodopa. On the other hand, if the symptoms are making it difficult to write, dress, or walk, then Levodopa may be the best choice to improve function and comfort.

In addition to medication, there are non-drug approaches that can help manage the disease. Regular exercise, including aerobic and strength training, may slow disease progression. Physical therapy programs, such as the LSVT BIG (Lee Silverman Voice Treatment BIG) program, are also helpful in improving movement and reducing slowness. It is important to talk to your doctor about how your symptoms are affecting your life so you can decide together when to begin treatment.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.