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Take Rasagiline or wait?

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I am 54 and diagnosed with PD about 2 month ago and was confirmed with a DaT Scan a month ago.  My symptoms start about 2 years ago.  I'm told by my neurologist (MDS) that my symptoms are mild and I'm in early stage.   I have tremors on my left side hand, foot and leg (but they are not constant), some shuffling of my left foot when walking and some occasional tripping.   I also have some concentration problems, word loss, have difficulty with multi tasking and decision making, but I have not experienced depression.   I feel like my symptoms are annoying but nothing I cannot deal with at this point, since I've been dealing with them for 2 years.  My doctor has recommended starting off with Rasagiline.  I'm leaning towards waiting to start meds until my symptoms become more bothersome but would love to heard others opinion if it's better to start or wait? I  understand studies have shown to slow progression temporarily but will eventually catch up.  Start or wait??

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It may delay your PD. So yes I would take it.also consider Ashwaghnda, Shankhapushpi. They are excellent brain tonics. Don’t forget to exercise too

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You can try it.  I tried that medication but had a bad reaction to it.  I can detail that for you if you'd like.  Point being is any drug will cause bad reactions in certain people, so just be aware of what can happen and be cautious if you do start taking it.  

 

The data supporting the ability of any drug, including rasagiline (aka Azilect), to slow progression is mixed at best.  Same goes for herbal remedies like ashwaghanda and whatever else waruna likes to promote.  However, if you feel better for taking any particular drug or herbal supplement then it might be worth the expense for you.

 

The only thus far proven to actually help slow progression is exercise.  Unless you're already a competitive athlete in your age class you can probably increase your level of exercise and obtain some benefit.  

 

As far as take it or wait, that's a decision you'll have to base on the cost for the medication vs the potential benefits.  Rasagiline is, last I heard, only available through 1 drug company as a generic, so cash price isn't tremendously lower than brand name Azilect.  Not all insurance plans will cover it.  But Teva (the maker of Azilect brand rasagiline) might have a patient assistance program where, depending on your income level, you might be able to get it at a significant discount, or at no charge at all.  Worth checking into if you decide to go for it.

 

Personally, and this is just IMHO, and based on my own situation, if I were you I would either decline all drugs, or look into a low dose of carbidopa/levodopa to see if that gives you the relief you want.  For me at least I got excellent motor symptom control from that, and some benefit to non-motor symptoms too.  The latest research is showing that starting that early vs later does not influence if/when you'd start to develop the main bad side effect of dyskinesia.

 

Meantime I would be talking to my insurance company to see how they cover rasagiline (if they cover it at all), and also calling the drug companies to see what they can do to help cover the cost.  Then, if between insurance and drug company discounts/coupons/assistance, rasagiline is affordable I'd start on a trial of that. 

 

In any case, getting on an exercise program (anything that you will actually stick with is fine - if you don't know where to start look up cardio based programs like running, bicycling, swimming, etc.)

Edited by stump

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