{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T14:24:49Z","timestamp":1761488689700,"version":"3.44.0"},"reference-count":33,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pract Neurol"],"published-print":{"date-parts":[[2011,6]]},"abstract":"<jats:p>Many clinicians regard levodopa as a last resort in the symptomatic treatment of Parkinson's disease. Here we critically review the arguments that are typically used to postpone the start of levodopa for as long as possible. We will point out that most concerns are invalid. Levodopa remains the most effective and best tolerated Parkinson's drug to date, and should have an important role in all therapeutic strategies, both as monotherapy in early Parkinson's disease and as part of combination therapy in advanced disease. Regardless of disease stage, the choice of a particular drug should not be driven by fear of long term complications but by the clinical condition of the patient at the time, with an emphasis on functioning in everyday life and any comorbidity. A \u2018phobia\u2019 for levodopa\u2014or, indeed, for any other antiparkinsonian medication\u2014is unacceptable according to current evidence.<\/jats:p>","DOI":"10.1136\/practneurol-2011-000011","type":"journal-article","created":{"date-parts":[[2011,5,6]],"date-time":"2011-05-06T00:33:01Z","timestamp":1304641981000},"page":"145-152","source":"Crossref","is-referenced-by-count":18,"title":["The treatment of early Parkinson's disease: levodopa rehabilitated"],"prefix":"10.1136","volume":"11","author":[{"given":"Annemarie","family":"Vlaar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ad","family":"Hovestadt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teus","family":"van Laar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastiaan R","family":"Bloem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2011,5,5]]},"reference":[{"key":"2025090411270690000_11.3.145.1","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1056\/NEJM196902132800701","article-title":"Modification of Parkinsonism\u00e2\u0080\u0094chronic treatment with L-dopa","volume":"280","author":"Cotzias","year":"1969","journal-title":"N Engl J Med"},{"key":"2025090411270690000_11.3.145.2","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1212\/01.WNL.0000152880.77812.5B","article-title":"\u00e2\u0080\u0098Levodopa phobia\u00e2\u0080\u0099: a new iatrogenic cause of disability in Parkinson disease.","volume":"64","author":"Kurlan","year":"2005","journal-title":"Neurology"},{"key":"2025090411270690000_11.3.145.3","doi-asserted-by":"publisher","DOI":"10.1002\/mds.1090"},{"key":"2025090411270690000_11.3.145.4","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1002\/mds.21126","article-title":"Longitudinal study of the motor response to levodopain Parkinson's disease","volume":"21","author":"Clissold","year":"2006","journal-title":"Mov Disord"},{"key":"2025090411270690000_11.3.145.5","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1001\/archneur.63.2.205","article-title":"Levodopa-associated dyskinesia risk among Parkinson disease patients in Olmsted County, Minnesota, 1976\u00e2\u0080\u00931990","volume":"63","author":"Van Gerpen","year":"2006","journal-title":"Arch Neurol"},{"key":"2025090411270690000_11.3.145.6","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20243"},{"key":"2025090411270690000_11.3.145.7","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1002\/mds.20360","article-title":"Levodopa-dyskinesia incidence by age of Parkinson's disease onset","volume":"20","author":"Kumar","year":"2005","journal-title":"Mov Disord"},{"key":"2025090411270690000_11.3.145.8","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1002\/ana.410250521","article-title":"Pathogenesis of dyskinesias in Parkinson's disease","volume":"25","author":"Mouradian","year":"1989","journal-title":"Ann Neurol"},{"key":"2025090411270690000_11.3.145.9","doi-asserted-by":"crossref","first-page":"S495","DOI":"10.1002\/mds.22048","article-title":"Levodopa therapy for Parkinson's disease: challenges and future prospects","volume":"23","author":"Olanow","year":"2008","journal-title":"Mov Disord"},{"key":"2025090411270690000_11.3.145.10","unstructured":"Bloem BR Roos RA . 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