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

Findings That Should Speed The Development Of Drugs For Parkinson's Disease
Source: Health News from Medical News Today [2009.11.19]
Australian scientists have significantly advanced our understanding of dopamine release from nerve cells, findings that should speed the development of more effective drugs for treating Parkinson's Disease. People with Parkinson's Disease suffer from muscle rigidity, tremor, a slowing of physical movement and, in extreme cases, a loss of physical movement.

Progression Of Parkinson's Disease May Be Prevented By Widely Used Cholesterol-Lowering Drug
Source: Statins News From Medical News Today [2009.10.31]
Simvastatin, a commonly used, cholesterol-lowering drug, may prevent Parkinson's disease from progressing further. Neurological researchers at Rush University Medical Center conducted a study examining the use of the FDA-approved medication in mice with Parkinson's disease and found that the drug successfully reverses the biochemical, cellular and anatomical changes caused by the disease.

Avian Influenza Strain Primes Brain For Parkinson's Disease
Source: Bird Flu / Avian Flu News From Medical News Today [2009.08.11]
At least one strain of the H5N1 avian influenza virus leaves survivors at significantly increased risk for Parkinson's disease and possibly other neurological problems later in life, according to new research from St. Jude Children's Research Hospital.

Parkinson's Disease
Source: MedicineNet Amyotrophic Lateral Sclerosis Specialty [2009.04.28]
Title: Parkinson's Disease
Category: Diseases and Conditions
Created: 12/31/1997
Last Editorial Review: 4/28/2009

NC State Researchers Advance Understanding Of Stem Cells
Source: Genetics News From Medical News Today [2009.11.19]
Researchers from North Carolina State University have identified a gene that tells embryonic stem cells in the brain when to stop producing nerve cells called neurons. The research is a significant advance in understanding the development of the nervous system, which is essential to addressing conditions such as Parkinson's disease, Alzheimer's disease and other neurological disorders.

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Published Studies Related to Selegiline

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.

A review of the literature on the selegiline transdermal system: an effective and well-tolerated monoamine oxidase inhibitor for the treatment of depression. [2008]
Objective: To provide a narrative review of the properties of the selegiline transdermal system (STS) for the treatment of depression and its subtypes.Background: Monoamine oxidase inhibitors (MAOIs) once represented the mainstay of therapy for the treatment of major depressive disorder (MDD)... As a result, treatment at the lowest effective dose of 6 mg/24 hours can be administered without the need for dietary modifications.

Selegiline transdermal system (STS) for HIV-associated cognitive impairment: open-label report of ACTG 5090. [2007.11]
CONCLUSION: Long-term use of selegiline was safe and well tolerated in this HIV cohort of HIV with cognitive impairment. Cognitive improvement may be delayed in neuroprotective trials, suggesting that trials longer than 6 months may be necessary to assess the efficacy of putative neuroprotective agents.

Efficacy of selegiline add on therapy to risperidone in the treatment of the negative symptoms of schizophrenia: a double-blind randomized placebo-controlled study. [2007.10.31]
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. Copyright (c) 2007 John Wiley & Sons, Ltd.

Pharmacokinetics and absolute bioavailability of selegiline following treatment of healthy subjects with the selegiline transdermal system (6 mg/24 h): a comparison with oral selegiline capsules. [2007.10]
The selegiline transdermal system is a monoamine oxidase inhibitor that was recently approved by the US Food and Drug Administration for the treatment of major depressive disorder. The current study was conducted during the selegiline transdermal system development program to characterize the single-dose pharmacokinetics and absolute bioavailability of selegiline administered by the 6-mg/24-h selegiline transdermal system in healthy volunteers...

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Clinical Trials Related to Selegiline

Evaluation of Adhesion and Dermal Tolerability of EMSAM [Completed]

Safety and Effectiveness of the Selegiline "Patch" for Decreased Mental Function in HIV Patients [Active, not recruiting]
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.

PK Comparison of 6mg and 12mg EMSAM in Elderly vs. Non-Elderly [Completed]
Evaluate the effect of age on the PK of two different doses of EMSAM.

Selegiline as an Aid to Smoking Cessation [Not yet recruiting]

This research study of 246 participants is designed to determine if the selegiline transdermal system (STS - a drug administered in skin patch form), in combination with weekly brief behavioral therapy, is efficacious as an aid to quitting smoking in heavy smokers (those who smoke 20 or more cigarettes every day). It is a placebo-controlled study, meaning that participants will be randomly assigned to receive either a patch with active drug or a matching patch which contains no drug. Participants will apply the active or placebo patch once per day for 8 weeks and, in addition, all will receive brief behavioral intervention for 8 weeks. Participants will be asked to complete assessments (questionnaires, laboratory tests, etc.) at various times in the 8-week treatment phase of the study as well as at 4 weeks and 18 weeks after completing treatment (weeks 12 and 26, respectively).

Assessment of Potential Interactions Between Methamphetamine and Selegiline - 1 [Active, not recruiting]
The purpose of this study is to assess the potential interactions between intravenous methamphetamine and oral selegiline.

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PATIENT REVIEWS / RATINGS / COMMENTS

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 47 year old female patient
		Rating
Overall rating:
Effectiveness:		Moderately Effective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		attention deficit problems, concentration difficul
Dosage & duration:		10 mg taken daily for the period of since March 2007
Other conditions:		frontal lobe atrophy
Other drugs taken:		melatonin
		Reported Results
Benefits:		During the first two weeks no notable benefits, but after that there was a distinct difference; the brain fog seemed to have disappeared, general mental state and motivation improved. However, there was no significant change as to the ability to concentrate which continued to be as poor as before. On doctor's advice the dosage was increased to 20mg per day but due to side-effects on that dose had to return to the previous dose (10mg daily)
Side effects:		On the larger dosage of 20mg per day: dizziness, rapid heart rate, general feeling of nausea
Comments:		See as stated above. Since this drug didn't really work on add-symptoms as efficiently as was expected the patient will ask her neurologist for a prescription of either Ritalin or Concerta or something similar especially for improving concentration.

Selegiline review by 47 year old female patient
		Rating
Overall rating:
Effectiveness:		Moderately Effective
Side effects:		No Side Effects
		Treatment Info
Condition / reason:		attention deficit problems, concentration difficul
Dosage & duration:		10 mg taken daily for the period of since March 2007
Other conditions:		frontal lobe atrophy
Other drugs taken:		melatonin
		Reported Results
Benefits:		During the first two weeks no notable benefits, but after that there was a distinct difference; the brain fog seemed to have disappeared, general mental state and motivation improved. However, there was no significant change as to the ability to concentrate which continued to be as poor as before. On doctor's advice the dosage was increased to 20mg per day but due to side-effects on that dose had to return to the previous dose (10mg daily)
Side effects:		On the larger dosage of 20mg per day: dizziness, rapid heart rate, general feeling of nausea
Comments:		See as stated above. Since this drug didn't really work on add-symptoms as efficiently as was expected the patient will ask her neurologist for a prescription of either Ritalin or Concerta or something similar especially for improving concentration.