Parkinson's disease: Seven questions physicians often ask

Tanya Simuni*, Matthew B. Stern

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Parkinson's disease (PD) is a clinical diagnosis, based on the identification of parkinsonism, determination of its cause, and a positive clinical response to drug therapy. Six major groups of agents help control symptoms; levodopa, in combination with carbidopa, is the most effective, although each group of agents has a therapeutic niche. For example, dopamine agonists are somewhat less effective than levodopa, but are less likely to produce drug-induced dyskinesias; they also have a longer half-life than levodopa and provide steadier dopamine-receptor stimulation. Tokapone allows higher levels of levodopa to cross the blood-brain barrier without increasing the levodopa dose. Selegiline may help slow progression of early PD. The diagnosis of PD does not necessitate immediate drug therapy; start treatment when symptoms affect the patient's functional level. Surgery is reserved for patients who fail to benefit from medical therapy.

Original languageEnglish (US)
Pages (from-to)367-381
Number of pages15
Issue number2
StatePublished - Feb 1 1999

ASJC Scopus subject areas

  • Medicine(all)


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