Selegiline in de novo parkinsonian patients: The finnish study

Publisher Website
Google Scholar
Abstract
Selegiline (L‐deprenyl) has been recommended as an antiparkinsonian drug to be used as an adjunct to therapy with L‐dopa, if and when L‐dopa starts to lose its effect. However, initial selegiline monotherapy followed by L‐dopa may be both effective and safe. A double‐blind, placebo‐controlled trial was carried out in previously untreated patients with Parkinson's disease randomized to receive selegiline (10 mg/day; 27 patients) or placebo (25 patients) until L‐dopa treatment became imperative. Three rating scales were used for assessment. The study design continues to be double‐blind even after L‐dopa is introduced. L‐Dopa was needed after 545 ± 90 days in the selegiline group. This was significantly later (p = 0.03) than after placebo (372 ± 28 days). Disability was less severe in the selegiline group, and there were no serious adverse effects. A nearly twofold dose of L‐dopa was needed in the placebo group to achieve a sufficient therapeutic effect during longterm treatment. These results show that selegiline is safe and effective as monotherapy in early parkinsonism. It delays the need for L‐dopa treatment and reduces the amount of daily L‐dopa required. This could be explained by either a symptomatic effect or neuroprotective efficacy or, more likely, a combination of both.