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In an open, uncontrolled study the longterm (9 years) effect of treatment with Madopar alone (n = 377) or in combination with l-deprenyl (selegiline, selective monoamine oxidase type B inhibitor) (n = 564) have been compared in Parkinsonian patients. In patients who lost their response to conventional Madopar therapy the addition of l-deprenyl resulted in a significant recouping of levodopa effect. The survival analysis revealed a significant increase of life expectancy in Madopar--l-deprenyl group regardless of the fact whether or not the significant demographic differences between the two groups were taken into account. Although the mechanism underlying this action of l-deprenyl is not known, the results are interpreted as indicating l-deprenyl's ability to prevent or retard the degeneration of striatal dopaminergic neurons. l-Deprenyl is the first anti-Parkinson drug having such a property. This hypothesis is not far fetched since l-deprenyl selectively prevents the degeneration of striatal dopaminergic neurons induced in animals by the illicit drug 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Since latter compound is known to cause Parkinsonism in man and primates or Parkinson-like neurochemical and pathological changes in other animals the implications of the present study involving monoamine oxidase activity and l-deprenyl are apparent.

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The potentiation of the anti akinetic effect after L-Dopa treatment by an inhibitor of monoamine oxidase (MAO) "B", Deprenil, has been demonstrated in parkinsonian patients with or without previous L-Dopa theapy. Application of the drug has been performed orally, intravenously and intramuscularly. Excellent kinetic effects resulted when combined with Madopar. The combined treatment with L-Dopa was highly effective when applicated i.v. or i.m. Deprenil is an inhibitor of MAO-B and is characterized by less frequent side effects. These are predominantly involuntary movements and confusion, which can be eliminated by lowering the dosage of Deprenil. A daily rhythm of MAO could be demonstrated in several areas of human brains as well as in a control group as in parkinsonian patients with or without L-Dopa therapy. Maximal activity of MAO occurs between noon and 6p.m. The clinical and biochemical data are discussed regarding the off-phenomenons as Deprenil is an excellent drug for preventing these.