Treatment

Treatment starts with correct diagnosis. Once diagnosed, doctors could be different in adopting the line of treatment.

In the case of YOPD, doctors differ in the treatment methods adopted like

  • Some may start with a dopamine agonist like pramipexole as a YOPD patient will live longer periods then a person with normal onset of PD at the age of 60+. They consider if ‘Levodopa/ Carbidopa’ is administered from the beginning, it might lose its efficacy in some years and thus reserve the levodopa for later.
    If your doctor treats you with Pramipexole, ask him the side effects of the medicine. Being on Pramipexole without knowing its side effect could be devastating and sometime can be life threatening. If your doctor has not disclosed voluntarily, then he either does not know or is too casual to have considered you to fall outside the percentage of people who get affected. Consider changing the Doctor.
  • Rotigotine patches: One patch lasts for 24 hours but these are not available everywhere and have their own set of side effects
  • Some start with the ‘levodopa/carbidopa’. With time, as the disease progresses the brain ability to generate dopamine reduces and not the medicine’s efficacy.
  • Some doctors treat with a combination of agonist and Levodopa/ Carbidopa and entacapone
  • As the disease progresses, symptoms become debilitating, and the doctors consider levodopa in itself or in combination with other drugs through oral administration cannot treat the disease effectively or the dose of levodopa cannot be increase further as it leads to dyskinesia – there are the following therapies to consider
  • Duo dopa infusion therapy
  • Apomorphine pump
  • DBS Surgery
  • Focused Ultrasound

The key to effective treatment is

  1. Choosing the doctor carefully. If available in your city, go to an ‘movement disorder specialist’ only and not to a general neurologist. In India, ever in bigger cities there is a practice of everyone treating every disease. As for me, I was consulting a general neurologist for the initial 8-9 years, who never ever told me the side effects of the medicine he was prescribing. I am in lot better hands now. Please ask questions to your doctor. It is said in PD the doctor -patient relationship is very important.
  2. Reading about and acquiring more and more knowledge about the disease, its treatment methods and their side effects and the advancement is the disease treatments. If you cannot read or have less time for it, may be your caregiver can keep abreast of the developments in the field. This attains importance in the case of YOPD as we must live with the disease and that it will progress with age.
  3. Confide in your doctor, do not hesitate. It is only when the doctor understands what is happening or what you are going through, he can do the optimum.
  4. Confide in your caregiver.