Treatment of Early Parkinson's Disease

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Treatment of early Parkinson's disease with either selegiline (Eldepryl), a dopamine agonist (pramipexole [Mirapex], ropinirole [Requip], or bromocriptine [Parlodel]), or the combination of levodopa and carbidopa (Sinemet) or levodopa and cabidopa with entacapone (Stalevo) improves symptoms and quality of life, but all medication regimens are associated with significant side effects (Table 1). There is no compelling evidence favoring a medication option, so treatment should be individualized. [Strength of recommendation: A, based on systematic reviews of randomized controlled trials (RCTs)]

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