Objective: We evaluated the efficacy of different starting drugs in the treatment of Parkinson’s disease (PD), in order to further explore the initial therapy of PD.

Background: Parkinson’s disease (PD) is a common neurodegenerative disease, there is no effective radical cure for PD because the pathogenesis is not clear. Anti-parkinsonism drugs, surgical operation and rehabilitation treatment are mainly used to relieve symptoms. Drug therapy plays an important role in improving the clinical symptoms of PD

Methods: From January 2006 to September 2016, 53 PD patients were enrolled in our study, including 31 cases into levodopa group, 22 cases into dopamine agonists group. We assessed clinical characteristics, Unified Parkinson’s Disease Rating Scale (UPDRS) scores, H&Y stage, Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HRSD), Epworth Sleepiness Scale (ESS), Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), and quality of life assessment scale (PDQ39) of all patients. An assessment was performed for 1 year and 5 years after the recruitment, and the incidence of symptom fluctuation and dyskinesia was recorded.

Results: In the baseline data, the equivalent dose of levodopa (p<0.001), UPDRSIII scores (p<0.05) and H&Y stage (p<0.05) were different between two groups of PD. In the first year of follow-up, the ESS scale of the dopamine receptor agonist group was more severe than that in the levodopa group (10.05 + 6.51 vs 6.68 + 5.19, respectively, p<0.05), and there were no differences in other aspects. In 5 years of follow-up, depression and anxiety scores of dopamine receptor agonist group were lower in the levodopa group (p<0.05). And the incidence of fluctuation is also lower in the dopamine agonist group, which is 27.27% compared to 58.06% (p<0.05).

Conclusions: PD patients in the dopamine agonist group were prone to daytime sleepiness in the early stage, but in the long term, the anxiety and depression scales were higher and the incidence of symptom fluctuation was lower in the dopamine agonist group than levodopa group.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-dopamine-agonists-versus-levodopa-as-initial-treatment-in-parkinsons-disease/