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ParkinsonsJournal
Decision guide

L-Dopa vs. Dopamine Agonists

At the start of drug therapy, the question of the right active substance often comes up. This guide compares the two most important options — as a basis for the conversation with your neurologist.

L-Dopa
Dopamine agonists
Strength of effect
Very high — the most effective option
Moderate to good
Typical use
From the mid-stage onward, older age
Often as first-line therapy, younger patients
Fluctuations in effect
Possible after years (wearing-off)
Rarer, more even effect
Possible side effects
Excess movements (dyskinesias)
Impulse-control disorders, fatigue
Dosing
Several times a day, timed carefully
Often once a day (extended-release)