Selegiline delays the onset of disability in Parkinsonian patients

Management of early Parkinson's disease.

Hauser RA, Zesiewicz TA

Department of Neurology,
Tampa General Hospital, Florida, USA
Med Clin North Am 1999 Mar;83(2):393-414, vi

Abstract

The two major questions in the treatment of early PD are
(1) Does selegiline slow neuronal loss and delay the progression of clinical disability? and
(2) Should dopamine agonists be used as initial symptomatic therapy in early disease rather than levodopa/PDI to reduce long-term disability and delay the onset of motor fluctuations and dyskinesia?
Selegiline affords neuroprotection for dopamine neurons in cell culture systems and the results of several clinical trials are consistent with the hypothesis that it is neuroprotective in Parkinson's disease.
Several clinical trials have found that initial symptomatic therapy with dopamine agonist to which levodopa/carbidopa is later added when needed leads to a lower incidence of long-term motor complications. These strategies are now being tested in prospective, randomized, blinded trials, many of which include PET or SPECT scans to assess the rate of dopamine neuron loss. These trials will provide more definitive answers to guide the early medial management of Parkinson's disease in the future.

Parkinson's research / abstracts

1.    Deprenyl effect on cognitive functions in early Parkinson's
2.    Deprenyl depression in Parkinson's disease
3.    Deprenyl stimulates biosynthesis of cytokines interleukin-1 & 6
4.    Deprenyl effect of MAO-B inhibitors on MPP+ toxicity
5.    Deprenyl modulates the decline of the dopamineric system
6.    Deprenyl possible mechanisms of action in Parkinson's
7.    Deprenyl pharmacological basis of the beneficial effects
8.    Deprenyl improves visuo-motor control in early Parkinsonism
9.    Deprenyl delays disability in Parkinsonian patients
10.   Deprenyl management of early Parkinson's disease
11.   Deprenyl delays the onset of disability in Parkinsonian patients
12.   Deprenyl and tocopherol antioxidative therapy of Parkinsonism