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Prognosis with Parkinson's changed when Levodopa came on the market back in the late '60s, early '70s. Before then, unfortunately, people passed away with Parkinson's after about 7-10 years. Since Levodopa came on the market, it was actually advertised, should we say, or shouted about that there was a normal lifespan was expected with Parkinson's due to the introduction of Levodopa. But the prognosis, from the point of view of the condition as well, has actually been split into stages. The first stage is obviously termed diagnosis, so it's your phase or the phase of the condition, the first one is when you're diagnosed, although this can take a couple of years because obviously, we have to wait for the symptoms to actually become more obvious. The second phase is then maintenance. So this is where people have been started on the medication and then managing relatively well on a small dose of their medications and maintaining their quality of life.
We then, in the third phase, go into one called complex. Now, this is when patients may well need a combination of medications and also have started to come across some of the side effects that are associated particularly with Levodopa in terms of the Dyskinesia. Unfortunately, people can get on-off with Levodopa after taking it for about five years. So that's when we have to then start playing clever, particularly with the medications, in trying to equal things out for them on a daily basis and trying to manage the side effects against the positives of the actual medications they're taking. So when we're discussing palliative stage, I think quite an important factor to state that people don't tend to die of Parkinson's disease; unfortunately, they die of associated problems, but not actually the disease itself.
This is why the condition can be very frustrating for people because no two people are the same, everybody's different and there is no standardisation to it. It very much depends on the individual and how the condition unwraps or develops for them. Again, this is exactly the same with the medications and managing the symptoms and what one person will have another won't. This then put us in a very difficult position when we're trying to actually deal with expectations. We can't be too specific and that's what then brings about major frustrations for the person who is trying to manage their disease.
