It can, however, delay the need for levodopa, so some experts recommend its use from first diagnosis although its value as a first-line treatment has not been confirmed. Selegiline can cause hypotension, nausea and vomiting, confusion and agitation, as well as increasing the side effects to levodopa. Lifestyle changes Patients should be encouraged to keep as active as possible and to look for other hobbies to replace those they can no longer do. The most beneficial activity is regular walking. Physiotherapists may recommend exercises to help mobility and pharmacists can offer various aids to everyday living.
Speech therapy can help communication in later stages of the disease.
As constipation is a common symptom, sufferers should be encouraged to eat a high fibre diet and drink at least eight to ten cups of liquid every day. Bulk laxatives are the most suitable if dietary adjustments are not enough. There is no firm evidence as yet that the anti-oxidant vitamins A,C and E slow the disease's progress, although such treatment might be justifiable in theory. References available on request.