Moderate Parkinson's disease. Strategies for maximizing treatment.

Motor fluctuations and dyskinesia often develop in patients with Parkinson's disease after 3 to 5 years of levodopa therapy. Dosage adjustments, addition of a second medication to the drug regimen, and dietary modifications may help maximize response to symptomatic therapy. Given the dramatic variability of symptoms and response to treatment, drug regimens must be individualized according to the patient's needs. In newly diagnosed cases of Parkinson's disease, administration of selegiline hydrochloride (Eldepryl) may slow symptom development and delay the need for levodopa therapy. Many physicians prescribe selegiline initially for its symptomatic and potential neuroprotective benefits.