MAO-B Inhibitors for Parkinson's Disease
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How It Works
Monoamine oxidase inhibitors (MAOIs) prolong the effects of dopamine in the brain by preventing its breakdown. They also may prevent the removal of dopamine between nerve endings and enhance release of dopamine from nerve cells. Rasagiline and selegiline are selective monoamine oxidase (MAO-B) inhibitors.
Why It Is Used
MAO-B inhibitors may be used in the early stages of Parkinson's disease to treat very mild symptoms (such as resting tremor) and delay the need for levodopa.
In people with advanced Parkinson's disease who are taking levodopa, rasagiline or selegiline may be added to levodopa treatment to reduce motor fluctuations, increase the time of effect of the levodopa, and decrease the amount of levodopa needed to control symptoms.
How Well It Works
In the early stages of Parkinson's disease MAO-B inhibitors may improve symptoms and can delay the need for levodopa. But the benefits are considered modest.1
MAO-B inhibitors are helpful to many people who have Parkinson's disease. Treatment with rasagiline or selegiline can:2
- Decrease "off" time.
- Reduce the amount of levodopa you need to take.
- Improve motor function and the ability to do daily activities as measured by a standard Parkinson's disease test.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
- Signs of dangerously high blood pressure, such as:
- Severe chest pain.
- Enlarged pupils.
- Fast or slow heartbeat.
- Severe headache.
- Increased sensitivity of your eyes to light.
- Increased sweating (sometimes with fever or cold, clammy skin).
- Severe nausea and vomiting.
- Stiff or sore neck.
Call your doctor if you have:
- Confusion, hallucinations, or mood or mental changes.
- Uncontrollable movements, such as twitching or repetitive movements of the tongue, lips, face, arms, or legs.
Common side effects of this medicine include:
- Belly pain or heartburn.
- Dizziness or lightheadedness.
- Dry mouth.
- Muscle or joint pain or stiffness.
- Nausea and vomiting (mild).
- Trouble sleeping.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
- Caslake R, et al. (2009). Monoamine oxidase B inhibitors versus other dopaminergic agents in early Parkinson's disease. Cochrane Database of Systematic Reviews (4).
- Stowe R, et al. (2010). Evaluation of the efficacy and safety of adjuvant treatment to levodopa therapy in Parkinson's disease patients with motor complications. Cochrane Database of Systematic Reviews (7).
Last Revised: December 5, 2012
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