How to differentiate the stages of PD?

Posted: Thu Apr 05, 2007 2:05 am Post subject: How to differentiate the stages of PD?

As PD patient has different syndromes and varies one after by other is it hard for the Movement Disorders Specialists to differentiate the stages of PD? Is it subjective? In this connection how to differentiate the stages of PD? Is it difficulty for them to optimize the combination of Medicine and PD? Some specialists favour of the high dose of PD and some are not as they start first with the low doses as PD medication has wearing off ? Is it helpful for PD patient starts of low doses or high doses to slow down the PD progression? My doctor favours with low doses for the new patient? Kindly elaborate?

TEO KIM HOE
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Dr. RodriguezJoined: 22 Jan 2007Posts: 0Location: Gainesville, Fl
Posted: Thu Apr 05, 2007 3:43 pm Post subject:

For any medical condition, the goal of the physician is to treat with the lowest effective dose. As of today, no medication have been proven to slow down the progression of the disease, so there is no need to prescribe very high dosages (however, some MD's may have their own opinions based on selected information they may have reviewed, not necessarily evidence based). The stages of PD used are the H & Y, not defined by the time the patient has been diagnoses, but by symptoms. For example, somebody may have just been diagnosed, may have very mild disease (tremors, slowness) but have balance problem. Automatically, this is a Stage 3. The way I defined it for myself is as follows. Anyone doing well on a 3-4 times a day regimen without wearing off, is early. If wearing off or mild dyskinesias, is moderate. When we as physicians pull our hair and have to reinvente the regimens, there are many motor fluctuations and they are unpredictable, that is advanced. Again, this is my definition and how I address therapy for my patients, is not a validated scale._________________Ramon L Rodriguez