UNASSIGNED: There are many guidelines available concerning the treatment of @entity191 . Most of these advocate treating young-onset @entity1 with a @entity935 agonist and older @entity1 with @entity3034 . The rationale behind this recommendation has its origins in the side effects associated with each of these drug classes: whilst @entity3034 leads to @entity910 , which may not be relevant for @entity1 with a limited life-expectancy, @entity935 agonists have a much longer plasma half life which probably leads to more continuous @entity935 receptor stimulation and thus decreases the occurrence and severity of @entity910 . However, the side effects associated with the use of @entity935 agonists, such as @entity25 , orthostatic problems, @entity1833 and @entity23 are a drawback. In this overview, the hypothesis will be put forward that perhaps such a strict distinction is no longer needed. A new idea may be the early combination of @entity3034 with a @entity935 agonist which would provide good clinical efficacy and, because of the relatively low doses involved, would reduce the side effects associated with both substances. @entity11927 inhibitors may be a good option for early treatment and especially for @entity1 who experience first motor fluctuations. Similarly, and particularly if a wearing-off symptom is present, @entity5549 inhibitors smoothen and prolong the action of @entity3034 . More invasive escalation therapy comes into play when @entity1 reach the advanced stages with problems of insufficient motor control, such as @entity2845 , @entity2003 and resting @entity400 , combined with on-time @entity910 . The use of all oral and invasive treatment has to be individualized to gain a good motor and non-motor control and especially a good quality of life.

Modern treatment in XXXX , a personal approach.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity3034 :: ('MESH:D007980', 'Chemical') :: ['levodopa'] @entity5549 :: ('1312', 'Gene') :: ['COMT'] @entity2003 :: ('MESH:D009127', 'Disease') :: ['rigidity'] @entity935 :: ('MESH:D004298', 'Chemical') :: ['dopamine'] @entity910 :: ('MESH:D004409', 'Disease') :: ['dyskinesia'] @entity191 :: ('MESH:D010300', 'Disease') :: ["Parkinson's disease"] @entity1833 :: ('MESH:D006212', 'Disease') :: ['hallucinations'] @entity23 :: ('MESH:D007174', 'Disease') :: ['impulse control disorders'] @entity2845 :: ('MESH:D018476', 'Disease') :: ['bradykinesia'] @entity400 :: ('MESH:D014202', 'Disease') :: ['tremor'] @entity11927 :: ('4129', 'Gene') :: ['MAO-B'] @entity25 :: ('MESH:D012893', 'Disease') :: ['sleepiness']
@entity191 :: (MESH:D010300,Disease) :: ['Parkinson's disease']
