Parkinson's: old active ingredient better than newer

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MunichParkinson's has been treated with levodopa for a very long time. Recently, however, there have been new drugs that promise fewer side effects. They are particularly preferred for younger patients. British scientists have now found out: Patients who take levodopa have a higher quality of life.

Symptom becomes a side effect

The Parkinson's drug levodopa has one major disadvantage: after a few years, taking it can lead to movement disorders such as muscle cramps or impaired movement coordination - although the active ingredient is intended to prevent precisely that. Newer drugs such as monoamine oxidase B inhibitors (MAO-B inhibitors) or dopamine agonists (DA) usually do not cause these symptoms. However, other side effects such as nausea, hallucinations, edema or insomnia are more common when taken.

Richard Gray and his colleagues at the University of Birmingham compared the three treatments in a large clinical study. They accompanied 1620 Parkinson's patients for seven years. 528 were treated with levodopa, 632 received DA and 460 received MAO-B inhibitors. The subjects filled out questionnaires in which they themselves assessed their mobility and quality of life on a scale from zero to one hundred.

More agile and less discomfort

The result: Study participants who took levodopa were more mobile in everyday life and rated their quality of life on average one to eight points better than those who swallowed new drugs. In addition, they complained less overall of physical complaints and had better perceptual and communication skills - despite the muscle cramps.

"Levodopa is still the best therapy for most patients," says Gray. In clinical operations, however, patients under the age of 70 would usually be given the new medication. According to the doctor, this practice must be reconsidered based on the results of the study.

Not enough dopamine

Parkinson's disease is a chronic disease of the brain. A lack of the messenger substance dopamine leads to disturbances in body movement, such as uncontrolled muscle tremors, stiffness or slowing of movement. Parkinson's is incurable. Medicines therefore do not fight the causes of the disease, but rather alleviate the symptoms of the patient. (away)

Source: Gray R. et al .: Long-term effectiveness of dopamine agonists and monoamine oxidase B inhibitors compared with levodopa as initial treatment for Parkinson's disease (PD MED): a large, open-label, pragmatic randomized trial, The Lancet, 10 June 2014

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