The First Few Years on a Dopamine Agonist Drug (Pramipexole, Ropinirole, or Pergolide)

Abstract In chapter 15 you read about how things typically go during the first few years of carbidopa/levodopa treatment. What if you started a dopamine agonist rather than carbidopa/levodopa after you were first diagnosed? Will the problems be the same? Will it go as smoothly? Will the dose need to be changed? Will carbidopa/levodopa be necessary and if so, when? In this chapter we will focus on these and other questions that arise when your only drug for PD is pramipexole, ropinirole, or pergolide. Parkinsonism tends to slowly worsen over months to years. This is never rapid but insidious. The dopamine agonist drugs are not as effective as carbidopa/ levodopa and they may become inadequate after one to a few years. Sometimes a dosage change is sufficient to overcome the problem, whereas in other cases, the addition of carbidopa/levodopa may be necessary.