Hi Kittens, I can give you my thoughts on the subject for you to think about, not necessarily act upon it ,but to think it all thoroughly through. I was 54 when diagnosed, started two years later on a dopamine agonist (Mirapexin) and after another 4 years added Sinemet.
When I started on mirapexin it was fairly new and had a short list of side effects. After years of large numbers, worldwide, of patients taking this, the side effect list is much more frightening and the medical literature tone more cautious about its use.
With all the information now available I would find the choice difficult : start with the DA or Sinemet? I would probably opt for the Sinemet. I find it works much better than the DA and has few side effects. Both are , I am sure , damaging in the long term, with drugs there is always a payback , but we like to be able to lead as normal a life as is possible with this disease and that is what levodopa does achieve (for a while). I like to take as few drugs as possible, otherwise you can no longer identify what causes which side effect or is it the interaction between the drugs.,etc.
If I had started on Sinemet four years earlier I might be very dyskinetic by now, who knows. Ideally I should have had an identical twin with PD, who had followed the levodopa route to compare notes with!
One piece of advice : learn as much as possible about the disease and the drugs. Best wishes, Kate