On 2014 Apr 09, David Keller commented:

Let the patient decide when to start medication for Parkinson disease

Reluctance to start medication is not a critical problem for patients with Parkinson disease (PD), because no medication has been proven to affect the underlying progression of PD. Patient "non-compliance" with the use of PD medications does not have the kind of downstream harms associated with non-compliance with statins or aspirin in patients with atherosclerotic vascular disease. On the other hand, delaying the use of levodopa is associated with delayed motor complications, such as dyskinesias. Patients should not be encouraged to take Parkinson medications unless they are needed, and the patient decides when they are needed, based on the way they feel, not the physician.

On 2014 Apr 09, David Keller commented:

Let the patient decide when to start medication for Parkinson disease

Reluctance to start medication is not a critical problem for patients with Parkinson disease (PD), because no medication has been proven to affect the underlying progression of PD. Patient "non-compliance" with the use of PD medications does not have the kind of downstream harms associated with non-compliance with statins or aspirin in patients with atherosclerotic vascular disease. On the other hand, delaying the use of levodopa is associated with delayed motor complications, such as dyskinesias. Patients should not be encouraged to take Parkinson medications unless they are needed, and the patient decides when they are needed, based on the way they feel, not the physician.