Apomorphine | Levodopa/carbidopa intestinal gel | Deep brain stimulation | |
---|---|---|---|
Age over 70 years | + | + | − |
Presence of comorbidities | − | + | − |
Severe speech disturbance | + | + | − |
Postural instability, falls | 0 | 0 | − |
Hallucinations/psychosis | 0 | + | + |
Impulse control disorders | 0 | + | + |
Excessive daytime sleepiness | − | 0 | 0 |
Mild dementia | 0 | 0 | − |
Moderate–severe dementia | − | − | − |
Moderate–severe depression | + | + | − |
Previous suicide attempts | 0 | 0 | − |
Dysphagia | + | + | − |
Weight gain | 0 | 0 | − |
Restless legs | + | + | 0 |
+=Presence of side effect/complication strengthens the decision to select the device-aided therapy.
0=Presence of side effect/complication does not influence the decision.
−=Presence of side effect/complication argues against selecting the device-aided therapy.
The table is based largely upon clinical experience and expert opinion in the absence of published robust comparative evidence.