Hi - Sorry to hear about your diagnosis but it is good that the meds help - we don't want the type of Pardinsonism disease where there meds don't help. The best thing to do is talk it over with your Neuro. Each of us ask the same question (100 million times) that you ask now. Everyone is different and there are so many different type meds. The Gold Standard is Sinemet and then there are meds that enhance the sinemet and sometimes the other meds actually work ok just on their own but then there are side effects of c/o behavior, etc. on and on and on. I have been diagnosed 2-1/2 years ago and finally started on sinemet a year ago (although I have been taking Azilect for 2 years) because the symptoms of pd were interfering with my job. Sinemet with Azilect works very well for me. At 74 you are probably not employed, I am assuming. But the best thing I did was read up on the meds and work with your Neuro. I copied the following from the Web MD site that the expert PD Dr. there said he uses to help patients with the med question:
Dear njladyluck,
This has been a question - unanswered - since the advent of levodopa in the 1970's. However, there have been some myths that have been created that often scare people with PD. The worst is that, "levodopa hastens the progression of PD." It does not!

Here are my general treatment guidelines about initiating treatment in patients recently diagnosed with PD:
1) listen to their concerns
2) give them time to accept that they have PD, and determine how they wish to move forward
3) educate them to their options, and try to help them figure out what would be best for them.

If those three things are accomplished, everything else is easier.

Now for treatment options. If you have only mild symptoms - mainly just occasional tremor - and the symptoms are on non-dominant side (e.g. left side if you are a righty), consider treatments that may affect the long-term prognosis. At this time the MAO-B inhibitors, such as rasagiline of selegiline, are the only agents used in clinical trials to assess "disease modification," so these are the drugs I discuss in this situation.

If you have mild to moderate symptoms, it effects both sides of the body, but no difficulty with balance, I first think about a class of drugs called "Dopamine Agonists." The generic names for these drugs are pramipexole, ropinirole and rotigotine (this comes in a skin patch). I begin these agents because they are highly effective, and not associated with "dyskinesias," wiggly/writhing type movements.

If you have symptoms on both sides of the body, and some balance concerns (or if you are concerned about losing your job), I think first about using carbidopa/levodopa or Sinemet. This is the most effective treatment for PD, but it is associated with dyskinesias. Dyskinesias are usually easy to manage, but if they emerge, they are quite worrisome to the patient. I prefer to delay this worry until my patients have reached a point of acceptance and peace with the fact they have PD.

With the initiation of any therapy, I try to keep the dosages low, and prefer to have low to moderate doses of a dopamine agonist and levodopa, rather than higher doses of just one.

And in regard to the same type question another post from the PD Expert at WebMD:

Your question is one that comes up in the life of every PD patient. Here are my basic guidelines. If you have mild symptoms, that do not cause any motor disability, there may be no reason to start a treatment. The PD community has longed for a medication that would delay the progression of the condition, but we still do not have a clear winner. There is a class of the medications called Mono-amine Oxidase Inhibitors, that have some data suggesting they are neuroprotective. There are two available: rasagiline and selegiline. Selegiline was approved in the 1980's and is available in generic. Rasagiline is available as Azilect in the United States, and in clinical trials the 1 mg dosage has delayed changes in a clinical rating scale. Unfortunately, the 2 mg did not show any difference. We do not know why.

Now, what if you are showing some mild to moderate motor symptoms? I would first suggest a dopamine agonist, such as pramipexole (Mirapex) or ropinirole (Requip). Both of these drugs have been shown to be highly effective in similar clinical trials. Another reason I choose this approach that these drugs are not associated with "dyskinesias" - involuntary movements associated with levodopa. These agents also have data suggesting there may also be some neuroprotective effects, but this is far from proven.

I recommend levodopa (Sinemet or Madapar) for patients who may not tolerate a dopamine agonist or for someone with motor disability to the point that they have balance problems. However, I do not think any physician is "wrong" to make this recommendation for an initial treatment.

Happy Reading