Selegiline delays the onset of disability in de novo
Parkinsonian patients. Swedish Parkinson Study Group.
Palhagen S, Heinonen EH, Hagglund J, Kaugesaar T,
Maki-Ikola O, Palm R,
Department of Neurology,
Neurology 1998 Aug;51(2):520-5
OBJECTIVE: The objective of this study was to investigate the effect of selegiline
first as monotherapy and then in combination with levodopa in the early phase of PD.
METHODS: A total of 157 de novo PD patients were randomized to receive either selegiline
or placebo in a double-blind study until levodopa therapy became necessary. Thereafter,
the drugs were withdrawn for an 8-week washout period to evaluate the possible symptomatic
effect of selegiline.
RESULTS: Analysis of Kaplan-Meier survival curves for each group
showed that selegiline delayed significantly the need for levodopa
therapy (p = 0.028). The semiannual rate of disability progression was slowed down
significantly in the selegiline group analyzed with the Unified Parkinson's Disease Rating
Scale (total and motor scores; p < 0.001). Selegiline had a "wash-in"
effect (i.e., an initial symptomatic amelioration of PD at 6 weeks and 3 months). However,
after the 8-week washout period, no significant differences in the deterioration of
disability between the groups was revealed in any of the scales, suggesting
that besides having a slight symptomatic effect, selegiline may also have neuroprotective
effects. Similarly, the progression of symptoms from baseline to the end of the
washout period was significantly slower (p = 0.033) in the selegiline group when the
progression was adjusted by the time to reach the end point. Selegiline was well
CONCLUSIONS: Selegiline delayed significantly the need to start levodopa in
early PD. After a 2-month washout period (before the start of levodopa therapy) no
significant symptomatic effect of selegiline was seen in comparison with the placebo
group, supporting the concept of neuroprotective properties of the drug.
research / abstracts
effect on cognitive functions in early Parkinson's
depression in Parkinson's disease
stimulates biosynthesis of cytokines interleukin-1 & 6
effect of MAO-B inhibitors on MPP+ toxicity
modulates the decline of the dopamineric system
mechanisms of action in Parkinson's
basis of the beneficial effects
control in early Parkinsonism
disability in Parkinsonian patients
early Parkinson's disease
onset of disability in Parkinsonian patients
antioxidative therapy of Parkinsonism