Selegiline for early Parkinson's disease is effective
Although rarely used, the monoamine oxidase type B inhibitor (MAOBI) selegiline could be one of the most effective treatments available for early Parkinson's disease, new research shows.
The drug fell from favour in 1995 when data from a trial suggested that
selegiline was associated with an increased mortality rate compared with
placebo. Other trials have failed to confirm this so researchers from
the University of Birmingham and Aberdeen Royal Infirmary decided to
examine available data on the effects of MAOBIs to clarify their role
in Parkinson’s disease.
They analysed data from 17 trials comparing MAOBIs with placebo or levodopa
and found that MAOBIs reduced disability, the need for levodopa and the
incidence of motor fluctuations without substantial side effects or increased
risk of death.
They suggest that the increased mortality rate seen in the 1995 trial
was a chance finding. “Our review provides no evidence that mortality
is increased by selegiline and suggests that this inexpensive drug could
be one of the most clinically effective and cost effective treatments
available for early Parkinson’s disease,” the researchers
say. However, they suggest that further long-term trials comparing selegiline
with other available drugs are needed.
The analysis is published on the BMJ website at BMJ Online
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