Deprenyl in the Treatment of Symptom Fluctuations in Advanced Parkinsonʼs Disease

Golbe, Lawrence I.; Lieberman, Abraham; Muenter, Manfred D.; Ahlskog, J. Eric; Gopinathan, Govindan; Neophytides, Andreas; Foo, S H; Duvoisin, Roger C.

doi:10.1097/00002826-198802000-00004

Cited by 122 publications

(47 citation statements)

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“…One Class III multicenter, double masked, parallel group study randomized 50 patients to selegiline (mean dose 10 mg/day) and 46 to placebo for 6 weeks. 15 There were greater than 80% completers (100% active, 93% controls). Fifty-eight percent of the selegiline group had improved "mean hourly overall symptom control" scores compared to 26% of the placebo group (p ϭ 0.002).…”

Section: R E T I R E D R E T I R E Dmentioning

confidence: 97%

Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): [RETIRED]

Pahwa¹,

Factor²,

Lyons³

et al. 2006

Neurology

464

314

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Section: R E T I R E D R E T I R E Dmentioning

confidence: 97%

Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): [RETIRED]

Pahwa¹,

Factor²,

Lyons³

et al. 2006

Neurology

464

314

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“…Although studies with selegiline have reported some improvement in motor fluctuations, the data are insufficient to quantify the impact particularly on endpoints such as "OFF" time [35][36][37]. This is especially true because the studies were conducted before PD home diaries gained wide acceptance.…”

Section: Mao-b Inhibitors Selegilinementioning

confidence: 99%

Patient Diaries As a Clinical Endpoint in Parkinson's Disease Clinical Trials

Papapetropoulos

2011

CNS Neuroscience & Therapeutics

121

106

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SUMMARYParkinson's disease (PD) is the second most common neurodegenerative disorder with an estimated 4 million patients worldwide. L‐dopa is standard, and often initial, therapy for patients with this condition; however, with continued dopaminergic treatment and as the disease progresses, the majority of patients experience complications such as “wearing‐off” symptoms, dyskinesias, and other motor complications. These complications may become disabling and profoundly affect quality of life. Treatment modification and combination therapies with L‐dopa, dopamine agonists, monoamine oxidase type B inhibitors, and catechol‐O‐methyltransferase inhibitors are commonly used to manage complications. In recent years regulatory agencies, clinical researchers, and sponsors have widely accepted and utilized changes in “ON” and “OFF” time measured by Patient Hauser Diaries as endpoints for measuring efficacy of therapeutics seeking approval for symptomatic treatment of PD. Successful antiparkinsonian medications have been associated with treatment effects of more than 1 h in either reduction of “OFF” time of increase in “ON” time. Accurate “ON” and “OFF” time registration during clinical studies requires rigorous patient training. Reduced compliance, recall bias and diary fatigue are common problems seen with patient diary reported measures. Electronic diaries may help reducing some of these problems but may be associated with other challenges in large, multicenter studies.

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“…One hundred and fourteen events were considered as possible health risks (63 without selegiline, 51 with selegiline), and 11 events were considered to pose definite health risks (6 without selegiline, 5 with selegiline). The adverse effects reported most commonly, regardless of the perceived seriousness, were lightheadedness (32 subjects), trouble falling asleep (28), nausea (23), skin rash (22), headache (21), dry mouth (19), and constipation (16). Neither the rate of occurrence of these adverse experiences nor that of coexisting conditions differed significantly between treatment groups except for dryness of the mouth (5 without selegiline, 14 with selegiline, p = 0.047).…”

Section: Mao-b Inhibitors For the Treatment Of Parkinson's Diseasementioning

confidence: 99%

MAO-B inhibitors for the treatment of Parkinson's disease

2002

Mov Disord.

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Early attempts to enhance dopaminergic neurotransmission through inhibition of one of dopamine's major metabolizing enzyme -monoamine oxidase (MAO) -were made soon after the discovery of the striatal dopaminergic deficit and the efficacy of L-dopa.1 However, side-effects ("cheese effect") associated with the non-selective type A plus B MAO inhibitors used in those days prevented further use. The development of selective MAO-B inhibitors through the work of Knoll et al.2 on Selegiline, however, re-introduced the concept of MAO-inhibition into the therapy of Parkinson's disease. 3 RATIONALEMAO-B inhibition blocks the metabolism of dopamine and therefore could enhance both endogenous dopamine and dopamine produced from exogenously administrated Levodopa. Furthermore, MAO-B inhibitors block the conversion of MPTP to its active metabolic MPP + , which is a selective substantia nigra neurotoxin suggesting that this class of agents could have neuroprotective properties. METHODS KEY SEARCH TERMSParkinson's disease, selegiline, MAO-B inhibitors, parkinsonism, neuroprotection, motor fluctuations.

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Deprenyl in the Treatment of Symptom Fluctuations in Advanced Parkinsonʼs Disease

Cited by 122 publications

References 0 publications

Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): [RETIRED]

Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): [RETIRED]

Patient Diaries As a Clinical Endpoint in Parkinson's Disease Clinical Trials

MAO-B inhibitors for the treatment of Parkinson's disease

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