Safety of Selegiline (Deprenyl) in the Treatment of Parkinson’s Disease

  title={Safety of Selegiline (Deprenyl) in the Treatment of Parkinson’s Disease},
  author={Esa H. Heinonen and Vilho V. Myllyl{\"a}},
  journal={Drug Safety},
Selegiline (deprenyl), a selective, irreversible inhibitor of monoamine oxidase type B (MAO-B) is widely used in the treatment of Parkinson’s disease. As the first MAO-B inhibitor approved for the treatment of Parkinson’s disease, concerns were raised about the safety of the drug based on the adverse effect profiles of older, nonselective MAO inhibitors. Unlike the nonselective MAO inhibitors, selegiline does not significantly potentiate tyramine-induced hypertension (the ‘cheese effect’) at… 
Selegiline: A Reappraisal of Its Role in Parkinson Disease
Results of the extensive body of clinical trials, including delayed and lower levodopa requirements, may indeed suggest that selegiline, in addition to conferring symptomatic benefit, may have other effects on disease progression.
Efficacy, safety, and patient preference of monoamine oxidase B inhibitors in the treatment of Parkinson’s disease
  • B. Robottom
  • Medicine, Biology
    Patient preference and adherence
  • 2011
This review focuses on rasagiline and selegiline, two medications that belong to a class of antiparkinsonian drugs called monoamine oxidase B (MAO-B) inhibitors.
MAO-inhibitors in Parkinson's Disease
In general, the clinical use of MAO-I nowadays is underestimated and there should be more efforts to evaluate their clinical potency as antidepressants and antidementive drugs in addition to the final proof of their disease-modifying potential.
Monamine Oxidase Inhibitors: Current and Emerging Agents for Parkinson Disease
A randomized clinical trial is underway to confirm preclinical and preliminary clinical data suggesting rasagiline has disease-modifying effects, and a new formulation of seLegiline (Zydis selegiline) has been evaluated in 2 small, placebo-controlled studies as adjunctive therapy to levodopa.
Monoamine Oxidase-B Inhibitors for the Treatment of Parkinson’s Disease: Past, Present, and Future
The effects of MAO-B inhibitors on motor and non-motor symptoms in PD patients, their mechanism of action, and the future development of MAo-B inhibitor therapy are discussed.
Clinical Pharmacokinetic and Pharmacodynamic Properties of Drugs Used in the Treatment of Parkinson’s Disease
No single best treatment exists for an individual patient with PD, and particularly in the advanced stage of the disease, treatment should be individually tailored.
Selegiline orally disintegrating tablets for the treatment of Parkinson’s disease
  • M. Lew
  • Medicine
    Expert review of neurotherapeutics
  • 2005
Adding selegiline orally disintegrating tablet to levodopa in patients experiencing ‘wearing-off’ episodes significantly decreases off time and increases dyskinesia-free ‘on’ time and significantly improves Unified Parkinson's Disease Rating Scale motor scores.
Droxidopa for the treatment of neurogenic orthostatic hypotension and other symptoms of neurodegenerative disorders
Results from a few small and short placebo-controlled trials and clinical studies in neurogenic OH showed significant reductions in the manometric drop of blood pressure after posture changes or meals, but larger Phase III studies suggest a positive effect of the drug on dizziness.
Long-Term Selegiline Monotherapy for the Treatment of Early Parkinson Disease
Long-term monotherapy with selegiline (10 mg/d) was effective and well tolerated in patients with early PD in this 56-week study.
Safety of Selegiline with Cold Medications
Patients taking selegiline should try to avoid pseudoephedrine and dextromethorphan or use drugs without interaction potential, and watch for adverse events or replace seLegiline with another drug.


Role of selegiline in combination therapy of Parkinson's disease
Early findings by Birkmayer et al showed that selegiline potentiated the efficacy of levodopa in the treatment of PD patients and was well tolerated, and this preliminary finding was followed by a number of trials assessing se LEGiline therapy in PD.
The effect of deprenyl (selegiline) on the natural history of Parkinson's disease.
Early deprenyl therapy delays the requirement for antiparkinsonian medication, possibly by slowing progression of the disease.
Psychiatric effects of selegiline.
  • S. Boyson
  • Medicine, Psychology
    Archives of neurology
  • 1991
Apparent adverse effects in the younger population were most common in physically small patients, especially women, and could be ameliorated by reduction of the dose of carbidopa/levodopa.
Selegiline in Parkinson's disease
The results are compatible with the possibility that treatment with selegiline without concomitant L‐dopa does not significantly increase DA concentration which remains low and is determined mainly by tyrosine hydroxylase activity, and the pathway of DA oxidation becomes more important only at higher DA concentrations.
Lack of adverse interactions between concomitantly administered selegiline and citalopram.
The present results indicate lack of clinically relevant pharmacodynamic or pharmacokinetic interactions between selegiline and citalopram.
Fluoxetine and Selegiline – Lack of Significant Interaction
  • C. Waters
  • Medicine, Psychology
    Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
  • 1994
In this clinic population, fluoxetine and selegiline were used in combination without major side effects, but further observation is warranted.
Serotonin syndrome and the combined use of deprenyl and an antidepressant in Parkinson's disease
All published case reports and adverse experiences reported to the U.S. Food and Drug Administration and the manufacturer of Eldepryl indicate that serious adverse experiences resulting from the combined use of deprenyl and an antidepressant medication in patients with PD are quite rare and that the frequency of the true “serotonin syndrome” is even rarer.
A controlled study of the antidepressant efficacy and side effects of (-)-deprenyl. A selective monoamine oxidase inhibitor.
It was concluded that (-)-deprenyl is an effective antidepressant in a dose range where it is distinguished by the absence of many of the side effects typical of nonselective MAO inhibitors.
Selegiline in the early and late phases of Parkinson's disease.
In severely disabled patients with irregular response swings or permanent akinesia the use of selegiline as an adjuvant drug cannot modify anymore the course of the disease.
Effect of lazabemide on the progression of disability in early Parkinson's disease
  • R Kieburtz
  • Medicine, Psychology
    Annals of neurology
  • 1996
At dosages ranging from 25 to 200 mg/day, lazabemide was well tolerated and delayed the need for levodopa in early, otherwise untreated Parkinson's disease (PD).