Of course, once upon a time—before scans and blood-tests even existed—this is how all diagnoses were made. So, in a sense, diagnosing Parkinson's disease gets back to very roots of what doctors are supposed to do. But when there are no corroborative tests available to prove or disprove a diagnosis, even doctor sometimes gets it wrong.

Before delving into challenges of diagnosing Parkinson's disease, let's first consider what is known about this condition.

In 1817 James Parkinson, an English surgeon and apothecary, published a classic, short book entitled "An Essay on Shaking Palsy." In it, Parkinson identified a consistent pattern of physical abnormalities in six patients he had examined. Although people with identical abnormalities had doubtlessly been around for thousands of years, Parkinson was first to recognize this pattern of abnormalities as a distinct condition. For this important achievement, disease was eventually named for him.

In book's opening sentence Parkinson wasted no time in laying out prominent features of this disease: "Involuntary tremulous motion, with lessened muscular power, in parts [of body] not in action and even when supported; with a propensity to bend trunk forwards, and to pass from a walking to a running pace: senses and intellects being uninjured."

Subsequently, scientists discovered that degeneration of a limited group of brain cells containing chemical transmitter dopamine was responsible for these clinical changes. (The group of brain cells involved is too slight to show up on brain scans in all but most advanced of cases.)

In 1967, levodopa (one of two ingredients in brand-name Sinemet) a drug body can convert into dopamine, was found helpful in alleviating many of symptoms. Later, other drugs (dopamine agonists) were created that improved symptoms by mimicking action of missing dopamine. These include bromocriptine (brand name Parlodel), pergolide (Permax), pramipexole (Mirapex) and ropinirole (Requip). To date, there are no treatments that reliably stop or reverse underlying disease-process.

Savings on brand name vs. generic drugs will vary from drug to drug and pharmacy to pharmacy but can be significant. Some remarkable examples:

Prozac brand 20mg, 100 tablets cost $280.19 Generic sells for $29.99 (Savings 89%)

Vasotec brand 5mg, 100 tablets costs $103.59 Generic sells for $18.19 (Savings 82%)

Ask Your Doctor is an Older Medication is as Effective - Often, physicians prescribe a newer drug that has been promoted as more effective. However, what this really means is that it is considerably more expensive. For example, newer antibiotics are often no more effective than older antibiotics. A great generic broad-spectrum antibiotic can cost 80% less than a new antibiotic.

Ask your doctor if you can take an over-the-counter (OTC, non-prescription) medicine - Sometimes an OTC medication can be as effective as prescription, and if it is, chances are OTC medicine will be considerably cheaper. For example, a one-month supply of Pepcid 20mg costs approximately $60. Pepcid AC, over-the-counter in 10mg strength (you would simply take two) costs approximately $23.

Cut Your Costs in Half by Using a Pill Splitter - Most pharmacies stock pill splitters. Sometimes, medications can be broken in half and save you 50%. Why? Several pharmaceutical manufacturers price some of their medications same for all strengths. For example, Lipitor is almost same price for all strengths. It’s possible to save as much as $100 on a one month supply of Lipitor just by getting larger strength and cutting in half. Ask your pharmacist.

If your medication can be split, make sure you do math. If higher dose is less than double cost for your regular dose then you will be saving money by having your doctor prescribe higher dose and then splitting it.

Disclaimer: Using a pill splitter is not appropriate for all medications and could be dangerous if done with wrong medication. Always ask your doctor or pharmacist if there would be any problems with splitting tablets or capsules.

Ask your doctor for a "trial prescription" when starting a new medication - If doctor does not have samples, ask your pharmacist to give you only a one-week supply to try. It is a federal law that medicines cannot be returned once they are dispensed. If you get a month's supply and can’t tolerate medicine or, you don't want to continue medicine, you'll have saved money by not buying a full prescription at start.

Ask for free samples of your prescription medicine - If it's your first prescription for a particular medicine, this is also a good way to "try" medicine to see how well it works for you and how well you tolerate any side effects. However, even though it is nice to have a free drug for a week or two, make sure it’s not a high-priced alternative that will end up costing you more when it comes time to pay for a full prescription.