Parkinson’s disease (PD) treatments, while effective, often come with side effects that challenge both patients and healthcare providers.

A recent study published in The Lancet offers new insights into managing these side effects, comparing the efficacy of three leading treatments.

Understanding Parkinson’s Disease and Its Treatment

Parkinson’s disease is characterized by symptoms like tremors and difficulty in movement stemming from the death of dopamine-producing brain cells.

Since the 1960s, Levodopa, a precursor to dopamine, has been a standard treatment, offering symptom relief. However, long-term use can lead to side effects like dyskinesias (uncontrolled movements) and fluctuating drug effectiveness.

Exploring Treatment Options

Besides Levodopa, other treatment classes include dopamine agonists (e.g., pramipexole, ropinirole, and rotigotine) and monoamine oxidase-B (MAO-B) inhibitors (e.g., rasagiline and selegiline). These drugs either mimic dopamine’s action or prevent its breakdown, maintaining its levels in the brain.

The PD MED Trial: A Comparative Study

The PD MED trial, the largest of its kind, compared Levodopa, MAO-B inhibitors, and dopamine agonists in 1,620 patients. The study assessed patients’ difficulty with typical Parkinson’s challenges, such as walking and daily activities.

Key Findings

  • Levodopa emerged as the most effective in controlling symptoms.
  • Only 2% of patients on Levodopa discontinued treatment due to side effects, compared to 28% on dopamine agonists and 23% on MAO-B inhibitors.
  • Despite Levodopa’s effectiveness, it’s not suitable for all, significantly younger patients due to long-term side effects.

Tailoring Treatment to Individual Needs

Tailoring Treatment to Individual Needs - Safe Therapeutics

The study underscores the importance of personalized treatment.

For instance, young-onset PD patients with mild symptoms might start with an MAO-B inhibitor or a dopamine agonist. However, those with more severe symptoms might require Levodopa for effective management.


While Levodopa remains a highly effective treatment for Parkinson’s disease, its long-term side effects necessitate a careful, individualized approach to therapy.

The PD MED trial highlights the need to balance efficacy with potential side effects, ensuring each patient receives the most suitable treatment for their specific condition.

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