When to Start Symptomatic Treatment

The time to initiate treatment with symptomatic medications in Parkinson's disease is also a bit controversial. While some would argue that a patient is presenting with symptoms and therefore deserves treatment to relieve those symptoms, most movement disorder specialists favor waiting to initiate treatment until disability in daily activities arises. Waiting to start levodopa treatment potentially delays the onset of motor fluctuations and, given the price of dopamine agonist medications, delaying treatment when disability is minimal is probably cost effective.