Conversation: The conversation between human and AI assistant.
[|Human|] Hi. I been diagnose as having idiopathic Parkinson disease.I seen seven top neurologist and have dat scan all confirm having PD. What they differ between them is treatment : 1-A group said,delay treatment as much as possible,to delay side effect,while one or more said,start immediatly as the delay treatment can cause more damage to the nerve cell .Who is right? 2-Some of them suggested take Dopamine producing medication while others suggested taking MAO B inhabited medication ,some both.Who is right? Many thanks.
[|AI|]  Brief Answer:You should start treatment when symptoms will interfere with your quality of life, when you will have functional disabilities. Based to your symptoms at the time of initiation of the therapy, and you age, the neurologist will help you to make the right therapeutic choice. Detailed Answer:Hello, Thank you for using Chat Doctor. I understand your concern. As you have seen lots of neurologists, I will try to give you an internist point of view. 1- Regarding the time of initiation of the treatment and the type of treatment in Parkinson disease there are not right and wrong choices, but appropriate choices based to the stage of the disease, the age of the patient and other preexisting diseases. It is recommended to start therapy when symptoms interfere with quality of life, when functional disabilities begin. As the Parkinson disease consists of a progressive, and irreversible loss of dopamine sensitive brain cells, at one point of your disease development you will need to be treated, but the doctors' goal is to delay treatment as much as your clinical situation allows it, in way to avoid Chat Doctor.  Even though there is a trend toward initiating therapy at the time of the diagnosis or early on the course of the disease, because patients may have some disabilities at an early stage, and there is a possibility that early treatment may preserve beneficial compensatory mechanisms. 2- What therapy to initiate ? Many experts favor starting with an MAO-B inhibitor in mildly affected patients because of the potential for a disease modifying effect. Meanwhile, dopamine agonists can be used for younger patients, with functionally significant disability to reduce the risk for motor complications (involuntary movements known as duskiness). And Levodopa for patients with more advanced disease, the elderly, or those with cognitive impairment. Combined therapy, is used in patients with motor complications.Meanwhile, exercise, education and support should be considered throughout the course of the disease. Hope this is helpful. Let me know if you need more clarifications. Otherwise, please close and rate the answer. Kind