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In parkinsonism monoamine oxidase-B inhibitors (e.g. selegiline, rasagiline)
- can be used to reduce the effective dosage of L-dopa and so reduce
the peripheral adverse effects of L-dopa therapy
out the fluctuations in dose-related anti-parkinsonism effects of L-dopa
help reduce the long-term adverse effects of L-dopa therapy, e.g. on/off phenomenon,
- initial studies of selegiline appeared to
suggest that selegiline may have a neuroprotective effect in Parkinson's disease;
more recent studies however have not substantiated this, and some evidence suggests
that the use of selegiline with L-dopa may in fact lead to a significantly increased
mortality. The chronic use of monoamine oxidase-B inhibitors in Parkinson's disease
is therefore controversial
NICE state that it is not possible to identify
a universal first-choice drug therapy for people with early Parkinson's disease
(PD). A possible inititial first-choice therapy is monoamine oxidase-B inhibitor
- monoamine oxidase-B inhibitors may be used as a symptomatic
treatment for people with early PD (2)
- monoamine oxidase-B inhibitors
may be used to reduce motor fluctuations in people with later PD (2)
CE. Managing early Parkinson's disease. The Practitioner 1999; 243: 39-47.
(June 2006). Parkinson's disease
- Lees AJ, on behalf of the Parkinson's
Disease Research Group. Comparison of the therapeutic effects and mortality data
of levodopa, levodopa in combination with selegiline, and bromocriptine in patients
with mild Parkinson's disease. BMJ 1995;311:1602-7.
- BMJ 1998; 316: 1191-6.
Last reviewed 01/2018