Pergolide and bromocriptine mimic dopamine's effects by stimulating the receptors in the brain to which dopamine normally binds. Eldepryl is believed to slow the process which leads to the death of the dopaminergic cells. These and other medications may be used alone, or in combination, depending on the patient's response, the preference of the treating physician, or other circumstances. In fact, a poor initial response to L-DOPA raises the possibility that the diagnosis of PD is incorrect. With time, the response to L-DOPA wanes.
Patients respond to the medication less consistently and for shorter periods of time.
In the off state, these patients are rigid and immobile. In the on state they are freer and have less tremor, but severe dyskinesias neutralize the medication's positive effects. For many, the dyskinesias are worse than the PD, causing patients to limit the amount of medicine they take or to discontinue their medication entirely. In the latter stages of the disease, patients may have terrible gait imbalance and recurrent falls. They respond poorly to medication and are wheelchair bound.