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Selegiline (Selegiline Hydrochloride) - Summary

 
 



SELEGILINE SUMMARY

Selegiline hydrochloride is a levorotatory acetylenic derivative of phenethylamine. It is commonly referred to in the clinical and pharmacological literature as l-deprenyl.

Selegiline hydrochloride is indicated as an adjunct in the management of Parkinsonian patients being treated with levodopa/carbidopa who exhibit deterioration in the quality of their response to this therapy. There is no evidence from controlled studies that selegiline has any beneficial effect in the absence of concurrent levodopa therapy.

Evidence supporting this claim was obtained in randomized controlled clinical investigations that compared the effects of added selegiline or placebo in patients receiving levodopa/carbidopa. Selegiline was significantly superior to placebo on all three principal outcome measures employed: change from baseline in daily levodopa/carbidopa dose, the amount of ‘off’ time, and patient self-rating of treatment success. Beneficial effects were also observed on other measures of treatment success (e.g., measures of reduced end of dose akinesia, decreased tremor and sialorrhea, improved speech and dressing ability and improved overall disability as assessed by walking and comparison to previous state).


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NEWS HIGHLIGHTS

Media Articles Related to Selegiline

UF researchers find memory problems in some people with Parkinson's disease
Source: Mental Health News From Medical News Today [2015.08.28]
Using a combination of neuropsychological testing and brain imaging, University of Florida researchers have discovered that in a group of recently-diagnosed patients with Parkinson's disease, about...

Promising drug for Parkinson's disease: Study supports fast track to clinical trials
Source: Liver Disease / Hepatitis News From Medical News Today [2015.08.10]
A drug which has already been in use for decades to treat liver disease could be an effective treatment to slow down progression of Parkinson's disease, scientists from the University of Sheffield...

Parkinson's Disease Quiz: Test Your Medical IQ
Source: MedicineNet amantadine Specialty [2015.02.20]
Title: Parkinson's Disease Quiz: Test Your Medical IQ
Category: MedicineNet Quiz
Created: 8/23/2011 12:53:00 PM
Last Editorial Review: 2/20/2015 4:38:06 PM

Scripps Florida scientists' 'mad cow' discovery points to possible neuron killing mechanism behind Alzheimer's and Parkinson's diseases
Source: CJD / vCJD / Mad Cow Disease News From Medical News Today [2015.02.16]
Scientists from the Florida campus of The Scripps Research Institute (TSRI) have for the first time discovered a killing mechanism that could underpin a range of the most intractable...

Parkinson's Disease
Source: MedicineNet Huntington Disease Specialty [2015.02.04]
Title: Parkinson's Disease
Category: Diseases and Conditions
Created: 12/31/1997 12:00:00 AM
Last Editorial Review: 2/4/2015 12:00:00 AM

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Published Studies Related to Selegiline

The relationship between depression and regional cerebral blood flow in Parkinson's disease and the effect of selegiline treatment. [2011.07]
OBJECTIVES: We examined the relationship between severity of depression in Parkinson's disease (PD) and regional cerebral blood flow (rCBF) using single photon emission computed tomography (SPECT) and the reaction to levodopa-selegiline combination therapy... CONCLUSIONS: These results indicate that selegiline controlled not only worsening of motor function and cognitive function in PD but also aggravation of minor depression, and restrained a fall in whole brain rCBF. (c) 2010 John Wiley & Sons A/S.

A double-blind, placebo-controlled, randomized clinical trial of oral selegiline hydrochloride for smoking cessation in nicotine-dependent cigarette smokers. [2010.03.01]
AIM: The primary aim of this study was to determine the safety and efficacy of the monoamine oxidase-B (MAO-B) inhibitor selegiline hydrochloride (SEL, l-Deprenyl; Eldepryl) as an aid for smoking cessation in cigarette smokers... CONCLUSIONS: Our results suggest that SEL was safe and well-tolerated by adult cigarette smokers, but did not improve smoking abstinence rates compared to PLO. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

A double-blind, placebo-controlled, randomized clinical trial of oral selegiline hydrochloride for smoking cessation in nicotine-dependent cigarette smokers. [2010]
l-Deprenyl; Eldepryl) as an aid for smoking cessation in cigarette smokers... CONCLUSIONS: Our results suggest that SEL was safe and well-tolerated by adult

Selegiline and oxidative stress in HIV-associated cognitive impairment. [2009.12.08]
OBJECTIVE: To assess the effectiveness of the selegiline transdermal system (STS) in reversing HIV-induced metabolic brain injury (as measured by proton magnetic resonance spectroscopy [MRS]) and in decreasing oxidative stress, measured by CSF protein carbonyl concentration... CONCLUSION: In this 24-week study, the selegiline transdermal system (STS) had no effect on either magnetic resonance spectroscopy (MRS) metabolites or oxidative stress, as measured by CSF protein carbonyl concentration. The lack of effect on these biomarkers is also reflected in the lack of cognitive improvement in the STS groups compared to placebo. Level of evidence: This study provides Class II evidence that STS had no effect on either MRS metabolites or oxidative stress, as measured by CSF protein carbonyl concentration over a period of 24 weeks.

Efficacy of selegiline add on therapy to risperidone in the treatment of the negative symptoms of schizophrenia: a double-blind randomized placebo-controlled study. [2008.03]
OBJECTIVE: It has been reported that selegiline, a Selective Monoamine Oxidase Inhibitor B (MAOI-B), at low doses would be helpful for treating negative symptoms in schizophrenia. Nevertheless, the results are contradictory so far. This study was designed to investigate the effect of selegiline added to risperidone as augmentation therapy in patients with chronic schizophrenia and prominent negative symptoms in an 8 week, double blind and randomized clinical trial... CONCLUSION: The present study indicates selegiline as a potential adjunctive treatment strategy for the negative symptoms of schizophrenia. Nevertheless, results of larger controlled trials are needed before recommendation for a broad clinical application can be made. (c) 2007 John Wiley & Sons, Ltd.

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Clinical Trials Related to Selegiline

Clinical Research Study to Evaluate Selegiline in the Treatment of Borderline Personality Disorder [Recruiting]
Selegiline is superior to placebo in improving psychological and physical functioning in patients with Borderline Personality Disorder.

Tolerability and Efficacy of Switch From Oral Selegiline to Orally Disintegrating Selegiline (Zelapar) in Patients With Parkinson's Disease [Completed]
Parkinson's disease (PD) is a progressive neurodegenerative disease. Symptomatic therapy is primarily aimed at restoring dopamine function in the brain. Oral selegiline in conjunction with L-dopa has been a mainstay of therapy for PD patients experiencing motor fluctuations for many years. The mechanisms accounting for selegiline's beneficial adjunctive action in the treatment of PD are not fully understood. Inhibition of monoamine oxidase (MAO) type B (MAO-B) activity is generally considered to be of primary importance. Oral selegiline has low bio-availability and is typically dosed BID, for a total of 5-10 mg daily. Recently, the FDA approved a new orally disintegration tablet (ODT) formulation of selegiline, called ZelaparTM. This new formulation utilizes Zydis technology to dissolve in the mouth, with absorption through the oral mucosa, thereby largely bypassing the gut and avoiding first pass hepatic metabolism. This allows more active drug to be delivered at a lower dose. Consequently, Zelapar is dosed once-daily, up to 2. 5 mg per day. There are no empirical data indicating whether the use of the new approved formulation of selegiline ODT (Zelapar) is superior or preferred by patients compared to traditional oral selegiline. It is believed that clinical efficacy will be preserved or enhanced, by delivering more active drug, with improved patient preference for the ODT formulation due to the once-daily dosing . The effectiveness of orally disintegrating selegiline as an adjunct to carbidopa/levodopa in the treatment of PD was established in a multicenter randomized placebo-controlled trial (n=140; 94 received orally disintegrating selegiline, 46 received placebo) of three months' duration. Patients randomized to orally disintegrating selegiline received a daily dose of 1. 25 mg for the first 6 weeks and a daily dose of 2. 5 mg for the last 6 weeks. Patients were all treated with levodopa and could additionally have been on dopamine agonists, anticholinergics, amantadine, or any combination of these during the trial. At 12 weeks, orally disintegrating selegiline-treated patients had an average of 2. 2 hours per day less "OFF" time compared to baseline. Placebo treated patients had 0. 6 hours per day less "OFF" time compared to baseline. These differences were significant (p < 0. 001). Adverse events were very similar between drug and placebo.

Efficacy of Orally Disintegrating Selegiline in Parkinson's Patients Experiencing Adverse Effects With Dopamine Agonists [Completed]
The purpose of the study is to determine if reducing or eliminating a dopamine agonist (DA) causing one of the side effects of daytime sleepiness, swelling of the lower legs or feet, hallucinations or impulsive behaviors while adding orally disintegrating selegiline can eliminate the adverse effect and maintain control of Parkinson's disease (PD) symptoms.

Effectiveness of Selegiline in Treating Marijuana Dependent Individuals - 1 [Completed]
During the past 15 years, the demand for treatment for marijuana-related problems in the United States has increased nearly twofold. Selegiline is a medication currently used to treat nicotine dependence. The purpose of this study is to evaluate whether selegiline may be useful in treating individuals with marijuana dependence.

Safety and Effectiveness of the Selegiline "Patch" for Decreased Mental Function in HIV Patients [Completed]
A decrease in mental function often occurs in patients with HIV. Antiretroviral (ARV) drugs are used to treat this but are not entirely effective. Some other therapy could play a role. The drug selegiline in its pill form is used to treat Parkinson's disease, a serious brain disorder. It is believed this drug might protect the brain and repair some damage. This study will use this drug in a "patch" form, which has not been approved by the Food and Drug Administration (FDA), to see if it helps with decreased mental function in patients with HIV. The purpose of this study is to evaluate the use of selegiline transdermal system (STS) in the treatment of decreased mental function in patients with HIV.

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Reports of Suspected Selegiline Side Effects

Hallucination, Visual (10)Pneumonia Aspiration (9)Intentional Overdose (9)Coma (9)Respiratory Failure (8)Convulsion (6)Confusional State (5)Dopamine Dysregulation Syndrome (5)ON and OFF Phenomenon (5)Myoclonus (5)more >>


PATIENT REVIEWS / RATINGS / COMMENTS

Based on a total of 4 ratings/reviews, Selegiline has an overall score of 7. The effectiveness score is 6.50 and the side effect score is 8.50. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.
 

Selegiline review by 36 year old male patient

  Rating
Overall rating:  
Effectiveness:   Highly Effective
Side effects:   No Side Effects
  
Treatment Info
Condition / reason:   increase dopmaine levels
Dosage & duration:   1mg taken taken: once per day for the period of taken: 5 times per week
Other conditions:   None
Other drugs taken:   None
  
Reported Results
Benefits:   increased synaptic dopamine levels. This gave me an amazing sense of wellbeing and clarity.
Side effects:   Positive side effects: see above
Comments:   I'm a healthy 36 year old with no medical conditions. I use Selegiline (L-deprenyl) purely to optimise my health and fortunately use a loop hole to import the drug into the country which does not have restriction importation for personal use

 

Selegiline review by 56 year old female patient

  Rating
Overall rating:  
Effectiveness:   Ineffective
Side effects:   Moderate Side Effects
  
Treatment Info
Condition / reason:   Head injury
Dosage & duration:   15mg taken daily for the period of 2 months
Other conditions:   Nil - TBI
Other drugs taken:   Citalipram
  
Reported Results
Benefits:   There were no noticable changes with selegiline, it was prescribed to help focus and attention for TBI.
Side effects:   Raised blood pressure, during the initial stages when increasing doseage became quite shaky at times and it appeared to be harded to start to walk, muscles seemed to be hesitant. These disappeared when stopped taking.
Comments:   take two and half tablets in the morning for two weekds then three tablets for two weeks then increas to 3.5 each morning (5mg)tabs

 

Selegiline review by 56 year old female patient

  Rating
Overall rating:  
Effectiveness:   Ineffective
Side effects:   Moderate Side Effects
  
Treatment Info
Condition / reason:   Head injury
Dosage & duration:   15mg taken daily for the period of 2 months
Other conditions:   Nil - TBI
Other drugs taken:   Citalipram
  
Reported Results
Benefits:   There were no noticable changes with selegiline, it was prescribed to help focus and attention for TBI.
Side effects:   Raised blood pressure, during the initial stages when increasing doseage became quite shaky at times and it appeared to be harded to start to walk, muscles seemed to be hesitant. These disappeared when stopped taking.
Comments:   take two and half tablets in the morning for two weekds then three tablets for two weeks then increas to 3.5 each morning (5mg)tabs

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Page last updated: 2015-08-28

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