[Disease Science] Patients with Parkinson’s disease should follow two points during drug treatment

The occurrence of dyskinesia complications is not only related to the long-term application of levodopa preparation, but also closely related to the total amount of medication, age of onset, and course of disease. The greater the total amount of medication, the longer the medication, the younger the age of onset, and the longer the course of the disease, the more likely it is to have motor complications. The latest research currently believes that as long as the total daily dose of levodopa does not exceed 400mg, it will not cause the complications of drug dyskinesia to appear early. Drug therapy should be started as soon as possible for the following reasons: First, early intervention can improve motor function and improve the quality of life. Second, Parkinson’s disease progresses faster in the early stage than in the late stage, which may be due to the existence of harmful compensation mechanisms in the early stage. 3. Start symptomatic treatment of medicines as soon as possible, which may interrupt harmful compensation and delay the development of the disease. Early medication is generally given as monotherapy. However, it can also be combined with optimized low-dose multiple drugs to achieve the best efficacy, longer maintenance time and the lowest incidence of dyskinesia complications. For early-onset patients, dopamine receptor agonists or monoamine oxidase-B inhibitors are generally used first, and late-onset patients prefer compound levodopa. Dopamine receptor agonists or monoamine oxidase-B inhibitors can delay the use of levodopa. Levodopa should start with a small dose, adhere to the principle of dose titration, and gradually increase the amount, as small as possible to achieve satisfactory clinical results. In the later stages of Parkinson’s disease, the efficacy of the drug gradually declined, and the duration of action of the drug became shorter and shorter, forcing patients to take larger and larger doses. At this time, complications of dyskinesia are inevitable. The mechanisms and treatment strategies of different types of motor complications are different, and it is the premise of reasonable treatment to clarify the type. At present, domestic and foreign countries have formulated corresponding treatment strategies based on different types of motor complications. For specific applications, it is recommended to fully consider the patient’s situation at the time and emphasize individualized drug treatment. 1. Achieve better results without causing abnormal movements. 2. Increase the number of times taken, reduce each dose, the daily dose remains unchanged. 3. Switch to a controlled-release dosage form and increase the dosage appropriately. 4. Add other drugs with relatively long half-life, such as dopamine receptor agonists, to provide relatively continuous dopaminergic stimulation, while reducing the amount of levodopa. 5. Add catechol-oxygen-methyltransferase inhibitors to increase the bioavailability of levodopa. 6. Don’t wait until the medical treatment is complete and the operation is over. In the early stage of the disease, when sports complications have not yet occurred, the goal of drug treatment should be to improve both sports symptoms and prevent sports complications. It is recommended to use dopamine receptor agonists and monoamine oxidase inhibitors alone. Those with poor symptom improvement or those with higher social work requirements can be combined with low-dose levodopa. During the course of the disease, the patient’s daily life activities and quality of life are severely impaired due to sports complications. The treatment goal should be medication, even surgical treatment to reduce Parkinson’s disease symptoms, improve sports complications, and improve the patient’s quality of life.

[Disease Science] Patients with Parkinson’s disease should follow two points during drug treatment

The occurrence of dyskinesia complications is not only related to the long-term application of levodopa preparation, but also closely related to the total amount of medication, age of onset, and course of disease. The greater the total amount of medication, the longer the medication, the younger the age of onset, and the longer the course of the disease, the more likely it is to have motor complications. The latest research currently believes that as long as the total daily dose of levodopa does not exceed 400mg, it will not cause the complications of drug dyskinesia to appear early. Drug therapy should be started as soon as possible for the following reasons: First, early intervention can improve motor function and improve the quality of life. Second, Parkinson’s disease progresses faster in the early stage than in the late stage, which may be due to the existence of harmful compensation mechanisms in the early stage. 3. Start symptomatic treatment of medicines as soon as possible, which may interrupt harmful compensation and delay the development of the disease. Early medication is generally given as monotherapy. However, it can also be combined with optimized low-dose multiple drugs to achieve the best efficacy, longer maintenance time and the lowest incidence of dyskinesia complications. For early-onset patients, dopamine receptor agonists or monoamine oxidase-B inhibitors are generally used first, and late-onset patients prefer compound levodopa. Dopamine receptor agonists or monoamine oxidase-B inhibitors can delay the use of levodopa. Levodopa should start with a small dose, adhere to the principle of dose titration, and gradually increase the amount, as small as possible to achieve satisfactory clinical results. In the later stages of Parkinson’s disease, the efficacy of the drug gradually declined, and the duration of action of the drug became shorter and shorter, forcing patients to take larger and larger doses. At this time, complications of dyskinesia are inevitable. The mechanisms and treatment strategies of different types of motor complications are different, and it is the premise of reasonable treatment to clarify the type. At present, domestic and foreign countries have formulated corresponding treatment strategies based on different types of motor complications. For specific applications, it is recommended to fully consider the patient’s situation at the time and emphasize individualized drug treatment. 1. Achieve better results without causing abnormal movements. 2. Increase the number of times taken, reduce each dose, the daily dose remains unchanged. 3. Switch to a controlled-release dosage form and increase the dosage appropriately. 4. Add other drugs with relatively long half-life, such as dopamine receptor agonists, to provide relatively continuous dopaminergic stimulation, while reducing the amount of levodopa. 5. Add catechol-oxygen-methyltransferase inhibitors to increase the bioavailability of levodopa. 6. Don’t wait until the medical treatment is complete and the operation is over. In the early stage of the disease, when sports complications have not yet occurred, the goal of drug treatment should be to improve both sports symptoms and prevent sports complications. It is recommended to use dopamine receptor agonists and monoamine oxidase inhibitors alone. Those with poor symptom improvement or those with higher social work requirements can be combined with low-dose levodopa. During the course of the disease, the patient’s daily life activities and quality of life are severely impaired due to sports complications. The treatment goal should be medication, even surgery to reduce Parkinson’s disease symptoms, improve sports complications, and improve the patient’s quality of life.