Increased life expectancy resulting from addition of l-deprenyl to Madopar� treatment in Parkinson's disease: A longterm study

Birkmayer, W; Knoll, J.; Riederer, Peter; Youdim, Moussa B. H.; Hárs, Vera; Marton, J.

doi:10.1007/bf01245973

Cited by 431 publications

(120 citation statements)

References 29 publications

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“…Clinical studies and experimental and animal models in the 1980s suggested that selegiline may delay disease progression [47], perhaps by reducing oxidative stress-related pathways causing dopaminergic neuronal death in the substantia nigra [48]. This led to the prospective investigation of the effect of selegiline on the natural progression of PD [26], and to the extensive DATATOP study, the first double-blind placebo-controlled neuroprotection trial [49].…”

Section: Selegilinementioning

confidence: 99%

Defining the Role of the Monoamine Oxidase-B Inhibitors for Parkinson’s Disease

Robakis

Fahn

2015

CNS Drugs

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Inhibitors of monoamine oxidase-B (MAO-B) occupy an important place in the treatment of Parkinson's disease. Selegiline was the first MAO-B to be used therapeutically, while rasagiline is a second-generation drug with higher potency and selectivity. Safinamide is an investigational MAO-B inhibitor with non-dopaminergic properties that may provide advantages over its predecessors. As a class, MAO-B inhibitors are safe and well tolerated and provide symptomatic benefit both as monotherapy and in combination with other antiparkinsonian medications from early to late stages of disease. In combination with levodopa, MAO-B inhibitors may improve motor fluctuations and allow for lower total doses of levodopa. Patient characteristics and preferences can be important factors in deciding between agents. As a class, MAO-B inhibitors have shown promise as disease-modifying agents, but the clinical trial evidence to date has not been strong enough to afford them such a label. Future research may help further elucidate their relative merits and clarify their role in altering disease progression. Key PointsRasagiline and selegiline are two monoamine oxidase-B (MAO-B) inhibitors commonly used in the treatment of Parkinson's disease (PD), while safinamide is an investigational agent of the same class.MAO-B inhibitors are safe, with few serious side effects, and provide mild but worthwhile improvements in the motor symptoms of PD, either as monotherapy or adjunctive to levodopa.The possibility that MAO-B inhibitors could slow down the progression of PD has been suggested by some studies but not by others and remains an open question.

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Section: Selegilinementioning

confidence: 99%

Defining the Role of the Monoamine Oxidase-B Inhibitors for Parkinson’s Disease

Robakis

Fahn

2015

CNS Drugs

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“…In addition these authors concluded that there is no evidence that deprenyl with levodopa decreased the excess mortality of Parkinson's disease contrary to Birkmayer et al retrospective study that suggested increased life expectancy. 5 The ratio of observed to expected deaths was 1.6 as compared to 1.46 on levodopa alone. The use of deprenyl did not appear to prevent progression of Parkinson's disease.…”

Section: Viewpoints On Deprenylmentioning

confidence: 99%

“…The majority of these studies have involved small numbers (20 to 56) of patients with variable study design. 5 " 9 Csanda and Tarczy, 5 showed that 20 of 30 patients treated with deprenyl monotherapy required other antiparkinsonian therapy within six months. Another study of 22 patients attempted to assess whether deprenyl halted the progression of the disease; it did not; and the study ended with the conclusion that it may still reduce the rate of progression.…”

Section: Deprenyl: the Exciting Possibility Of Protective Effect J Dmentioning

confidence: 99%

Deprenyl: Protective vs. Symptomatic Effect

Kofman

1991

Can. j. neurol. sci.

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“…7 Following this, the deprenyl and α-tocopherol antioxidative therapy of Parkinsonism (DATATOP) study was the first major clinical trial to attempt to ascertain whether selegiline might slow PD progression. Potential effects of α-tocopherol, a potent antioxidant, were simultaneously examined.…”

Section: Selective Monoamine Oxidase-b Inhibitors Selegilinementioning

confidence: 99%

Redefining Efficacy in Parkinson’s Disease—Early Motor Phase Treatments and the Potential for Treating during the Pre-motor Phase

Stone¹,

Jacoby²,

Henchcliffe³

2011

US Neurology

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Parkinson's disease (PD) is diagnosed on the basis of characteristic motor signs following clinical examination, and treatment has been overwhelmingly focused upon motor rather than non-motor symptoms until recently. Early and accurate detection of PD is considered desirable, with major research initiatives presently focused upon identifying and validating clinical batteries and biomarkers to this end. However, with increased appreciation of the occurrence of non-motor symptoms, and development of sophisticated biomarker methodology, it now seems possible to address risk assessment and diagnosis earlier in the course of the disease. The term 'Parkinson's associated risk syndrome' (PARS) has been coined to describe individuals at risk of developing PD, 1 and it is proposed that non-motor symptoms-for example, olfactory dysfunction, autonomic instability, constipation, and rapid eye movement (REM) sleep behavior disorder (RBD), in addition to neuroimaging or other biomarkers-might identify individuals in a 'pre-motor' phase of PD. 2,3Advances in understanding the course of PD raise the question of how the patient with pre-motor signs should be counseled and treated.Currently there are no approved treatments for pre-motor PD, and thus any pre-motor complaints are treated for specific symptom relief only;for example, RBD is treated by medications such as clonazepam rather than by addressing the possible underlying pathology. However, there is presently a growing number of clinical trials studying early PD, specifically assessing agents predicted to provide disease-modifying benefits. 4 Here we consider the medications approved for use in early motor PD, and examine clinical evidence for disease-modifying properties that might favor 'pushing back' their use to the pre-motor stage. We describe new approaches to disease modification, and their potential applicability to the pre-motor stage. We also consider the potential impact of existing and potential treatments on long-term outcomes, and the challenges in measuring their effectiveness. Effects of Antiparkinsonian Drugs in Early Parkinson's DiseaseMedications approved for use in early motor PD are almost exclusively aimed at motor symptoms and are summarized in Table 1. Their pharmacology and use in the clinical realm are well reviewed elsewhere, 5 and the American Academy of Neurology has published guidelines on the treatment of motor symptoms in early PD. 6 A major unmet need, however, is to slow the progression of PD. If such an intervention could be employed during early motor PD, it might provide long-term benefit AbstractUntil recently, Parkinson's disease (PD) treatments have overwhelmingly focused on motor rather than non-motor symptoms. Early and accurate detection of PD is considered desirable, with major research initiatives presently focused upon identifying and validating clinical batteries and biomarkers to this end. This raises the question of how the patient deemed at high risk of developing PD should be counseled and treated. Currently there are no a...

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Increased life expectancy resulting from addition of l-deprenyl to Madopar� treatment in Parkinson's disease: A longterm study

Cited by 431 publications

References 29 publications

Defining the Role of the Monoamine Oxidase-B Inhibitors for Parkinson’s Disease

Defining the Role of the Monoamine Oxidase-B Inhibitors for Parkinson’s Disease

Deprenyl: Protective vs. Symptomatic Effect

Redefining Efficacy in Parkinson’s Disease—Early Motor Phase Treatments and the Potential for Treating during the Pre-motor Phase

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