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Previous attempts at managing these patients by changing the dose of levodopa (increasing or decreasing it), the treatment schedule, or the ratio of levodopa to carbidopa or by temporarily discontinuing levodopa [drug holiday] were unsuccessful. The majority of our patients had diurnal fluctuations in performance, either \u201cwearing off\u201d or \u201con-off\u201d phenomena. The addition of a DA agonist resulted in a decrease in parkinsonian disability in most patients and a decrease in the severity of the diurnal fluctuations in performance. Improvement in many patients was maintained for at least 2 years. Adverse effects included mental changes, dyskinesias, orthostatic hypotension, and nausea. All of the adverse effects were reversible when the agonist was decreased or discontinued. As a group the agonists behaved similarly but individual patients often responded better to one agonist than another. The main role of agonists is in combination with levodopa in the treatment of patients with early PD who have not yet developed dyskinesias or diurnal fluctuations in performance.<\/jats:p>","DOI":"10.1017\/s0317167100037938","type":"journal-article","created":{"date-parts":[[2016,7,28]],"date-time":"2016-07-28T11:39:11Z","timestamp":1469705951000},"page":"466-473","source":"Crossref","is-referenced-by-count":22,"title":["D-1 and D-2 Agonists in Parkinson's Disease"],"prefix":"10.1017","volume":"14","author":[{"given":"Abraham N.","family":"Lieberman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menek","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Govindan","family":"Gopinathan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Neophytides","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2016,1,5]]},"reference":[{"key":"S0317167100037938_ref054","article-title":"Mesulergine in Parkinson\u2019s disease","author":"Gopinathan","journal-title":"Canad J Neurol Sci (submitted)"},{"key":"S0317167100037938_ref053","first-page":"503","article-title":"Neophytides A. 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