Should levodopa be used anymore?

Levodopa is the most potent dopaminergic oral drug available in clinical practice. After chronic treatment, many patients with Parkinson's disease develop dyskinesia and motor fluctuations which are difficult to manage. It was hoped that introduction of dopaminergic agonists could diminish these side effects while keeping the same efficacy as levodopa. Prospective clinical data do not support this idea with the present drugs. Levodopa remains the most useful treatment and most clinicians believe that it is wise to associate early on levodopa with one of the dopamine agonists.