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Selegiline

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Absorbed through the skin

Selegiline skin patch is used to treat mental depression. This medicine is a monoamine oxidase inhibitor (MAOI). This medicine is available only with… Read more

Brand names include: Emsam

By mouth

Selegiline is used in combination with levodopa or levodopa and carbidopa combination to treat Parkinson's disease (sometimes called shaking palsy or… Read more

Brand names include: Eldepryl, Zelapar

Drug classes About this
Antidepressant, Antiparkinsonian

What works? Research summarized

Evidence reviews

No evidence of benefit of selegiline for Alzheimer's disease

Despite its initial promise, i.e. the potential neuroprotective properties, and its role in the treatment of Parkinson's disease, selegiline for Alzheimer's disease has proved disappointing. Although there is no evidence of a significant adverse event profile, there is also no evidence of a clinically meaningful benefit for people with Alzheimer's disease. There would seem to be no justification, therefore, to use it for Alzheimer's disease, nor for any further studies of its efficacy in Alzheimer's disease.

Indirect meta-analysis of randomised placebo-controlled clinical trials on rasagiline and selegiline in the symptomatic treatment of Parkinson's disease

This review concluded that there were statistically and clinically significant benefits to rasagiline over selegiline for the treatment of Parkinson's disease, in terms of both efficacy and safety. There are concerns over the synthesis methods and the relatively small size and number of trials. The conclusions appear overly strong and may not be reliable.

Dementia: A NICE-SCIE Guideline on Supporting People With Dementia and Their Carers in Health and Social Care

This guideline has been developed to advise on supporting people with dementia and their carers in health and social care. The guideline recommendations have been developed by a multidisciplinary team of health and social care professionals, a person with dementia, carers and guideline methodologists after careful consideration of the best available evidence. It is intended that the guideline will be useful to practitioners and service commissioners in providing and planning high-quality care for those with dementia while also emphasising the importance of the experience of care for people with dementia and carers.

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Summaries for consumers

No evidence of benefit of selegiline for Alzheimer's disease

Despite its initial promise, i.e. the potential neuroprotective properties, and its role in the treatment of Parkinson's disease, selegiline for Alzheimer's disease has proved disappointing. Although there is no evidence of a significant adverse event profile, there is also no evidence of a clinically meaningful benefit for people with Alzheimer's disease. There would seem to be no justification, therefore, to use it for Alzheimer's disease, nor for any further studies of its efficacy in Alzheimer's disease.

Drugs that increase alertness (psychostimulants) for excessive daytime sleepiness (hypersomnia) in myotonic dystrophy

Myotonic dystrophy is an inherited muscular dystrophy causing muscle weakness and wasting. Many people with myotonic dystrophy complain about excessive daytime sleepiness. This symptom is related to disordered central respiratory control. Psychostimulants are drugs that increase alertness and include caffeine, amphetamine, selegiline, methylphenidate and modafinil. In this updated review there were few randomized controlled trials which evaluated the efficacy and safety of psychostimulants in myotonic dystrophy. One randomized controlled trial of selegiline involving 11 participants did not demonstrate any benefit. Four studies of another drug modafinil suggested inconsistent and slight benefits. Only two of these studies used the gold standard test, a sleepiness scale, to evaluate hypersomnia and found non significant improvement. In these four studies modafinil seemed well tolerated. Further randomized trials are needed to determine the utility of psychostimulants for myotonic dystrophy.

Monoamine oxidase B inhibitors for early Parkinson's disease

Parkinson's disease is a disabling condition of the brain characterized by slowness of movement, shaking, stiffness, and in the later stages, loss of balance. Many of these symptoms are due to the loss of certain nerves in the brain, which results in the lack of a chemical called dopamine. Current treatments for Parkinson's are designed to increase dopamine by using levodopa (Sinemet or Madopar), which is converted in the brain into dopamine, or drugs that mimic dopamine (dopamine agonists). Although useful, these treatments do not slow the progression of the disease and can be associated with side‐effects e.g. after a while levodopa use can cause involuntary movements (dyskinesia), painful leg cramps (dystonia) and a shortened response to each dose (motor fluctuations). Monoamine oxidase B (MAO‐B) inhibitors such as selegiline (Eldepryl or Selgene) boost the levels of dopamine by a different mechanism, which may reduce the risk of these complications and slow disease progression. We reviewed 11 controlled trials with a total of 2514 patients that compared giving MAO‐B inhibitors with not giving them in people with early Parkinson's to see if it was safe and effective. The results show that, although MAO‐B inhibitors do improve symptoms of Parkinson's and delay the need for levodopa by a few months, they are too weak to have a major effect and do not seem to delay the progression of the condition. They may, however, reduce motor fluctuations although more information is needed to be certain of this. Although they can cause some side‐effects, these are generally mild.

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