{"id":2849,"date":"2018-10-17T19:07:26","date_gmt":"2018-10-17T17:07:26","guid":{"rendered":"https:\/\/choosingwiselyitaly.org\/raccomandazione-prof\/do-not-delay-prescribing-levodopa-therapy-to-treat-patients-early-in-the-course-of-parkinsons-disease\/"},"modified":"2023-04-13T19:27:25","modified_gmt":"2023-04-13T17:27:25","slug":"do-not-delay-prescribing-levodopa-therapy-to-treat-patients-early-in-the-course-of-parkinsons-disease","status":"publish","type":"raccomandazione-prof","link":"https:\/\/choosingwiselyitaly.org\/en\/raccomandazione-prof\/do-not-delay-prescribing-levodopa-therapy-to-treat-patients-early-in-the-course-of-parkinsons-disease\/","title":{"rendered":"Do not delay prescribing levodopa if appropriate, and instead, do not use drugs for the complicated phase of the disease prematurely."},"content":{"rendered":"<p>Levodopa prescription as a drug treatment in Parkinson&#8217;s disease is often delayed in favour of other drug categories (such as dopamine agonists) due to concerns about the risk of drug-induced motor complications or levodopa toxicity. However, recent evidence has mitigated these concerns and thus levodopa can be introduced early if required by the patient&#8217;s clinical condition, although using a low dosage. Conversely, there is no evidence that the use of drugs indicated in the complicated phase of the disease (such as COMT catechol-O-methyltransferase inhibitors) reduce the risk of motor complications of the disease and should therefore be avoided in the earliest stages.<\/p>\n","protected":false},"featured_media":6422,"template":"","meta":{"_edit_lock":["1681406852:2"],"_edit_last":["2"],"_thumbnail_id":["6422"],"_wpml_word_count":["{\"total\":223,\"to_translate\":{\"it\":223}}"],"_yoast_wpseo_primary_eta":[""],"_yoast_wpseo_primary_disciplina":["111"],"_yoast_wpseo_primary_tipologia":[""],"wpcf-pacchetto":["LIMPE-DISMOV #1"],"wpcf-bibliografia":["1. Cilia R, Akpalu A, Sarfo FS, Cham M, Amboni M, Cereda E, Fabbri M, Adjei P, Akassi J, Bonetti A, Pezzoli G. The modern pre-levodopa era of Parkinson's disease: insights into motor complications from sub-Saharan Africa. Brain. 2014;137:2731-42\r\n2. Ferreira JJ et al. Summary of the recommendations of the EFNS\/MDS-ES review on therapeutic management of Parkinson\u2019s disease. 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