Entacapone and selegiline with l-dopa in patients with Parkinson's disease: an interaction study

Lyytinen, Jukka; Kaakkola, Seppo; Gordin, A.; Kultalahti, E.-R.; Teräväinen, H.

doi:10.1016/s1353-8020(00)00012-2

Cited by 8 publications

(3 citation statements)

References 21 publications

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“…A MAO‐B inhibitor might be expected to potentiate the effects of dopamine formed from L‐DOPA at the striatal level (Macinnes & Duty, ; Prat et al, ; Skuza et al, ). Indeed, although selegiline did not alter the overall score for motor disability, the duration of activity, as measured by a score less than 8, was increased by about 1 hr, reflecting the extension of L‐DOPA's response and reduced end of dose deterioration reported clinically (Fabbrini, Abbruzzese, Marconi, & Zappia, ; Lyytinen, Kaakkola, Gordin, Kultalahti, & Teravainen, ). To our surprise, we could find no prior investigation of the symptomatic effects of selegiline in MPTP‐treated primates, with the exception of one review that suggests that administration of selegiline increased the antiparkinsonian effects of levodopa and decreased dopamine metabolites (Nomoto, ).…”

Section: Discussionmentioning

confidence: 96%

The effect of Banisteriopsis caapi (B. caapi) on the motor deficits in the MPTP‐treated common marmoset model of Parkinson's disease

Fisher

Lincoln

Jackson

et al. 2018

Phytotherapy Research

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Banisteriopsis caapi (B. caapi) contains harmine, harmaline, and tetrahydroharmine, has monoamine oxidase inhibitory activity, and has reported antiparkinsonian activity in humans when imbibed as a tea; however, its effects are poorly documented. For this reason, motor function was assessed in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-treated common marmosets following administration of B. caapi extract (28.4-113.6 mg/kg; po), harmine (0.1 and 0.3 mg/ kg; sc), and selegiline (10 mg/kg; sc), alone or with a submaximal dose of L-3,4-dihydroxyphenylalanine (L-DOPA; 4-7 mg/kg). L-DOPA reversed motor disability, increased locomotor activity, and induced moderate dyskinesia. B. caapi did not increase locomotor activity or induce dyskinesia but at 56.8 and 113.6 mg/kg improved motor disability. The L-DOPA response was unaltered by co-administration of B. caapi. Harmine (0.1 and 0.3 mg/kg) produced a mild improvement in motor disability without affecting locomotor activity or dyskinesia but had no effect on the L-DOPA-induced antiparkinsonian response. Selegiline (10 mg/kg) alone improved motor function to the same extent as L-DOPA, but with only mild dyskinesia, and did not alter the response to L-DOPA, although dyskinesia was reduced. The findings suggest that B. caapi alone has a mild antiparkinsonian effect but does not enhance the L-DOPA response or reduce dyskinesia.

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Section: Discussionmentioning

confidence: 96%

The effect of Banisteriopsis caapi (B. caapi) on the motor deficits in the MPTP‐treated common marmoset model of Parkinson's disease

Fisher

Lincoln

Jackson

et al. 2018

Phytotherapy Research

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“…A total of 38 studies (6,338 patients) were included in the systematic review, including 27 RCTs and 11 observational studies ( Table 1 ). Twenty-three studies (Presthus et al, 1987 ; Hietanen, 1991 ; Nappi et al, 1991 ; Allain et al, 1993 ; Lees, 1993 ; Myllylä et al, 1993 ; Shoulson, 1993 , 1996 ; Mally et al, 1995 ; Olanow et al, 1995 ; Larsen and Boas, 1997 ; Pålhagen et al, 1998 , 2006 ; Larsen et al, 1999 ; Lyytinen et al, 2000 ; Shoulson et al, 2002 ; Weng et al, 2002 ; Su et al, 2004 ; Zhao et al, 2004 , 2005 ; Ye et al, 2014 ; Mizuno et al, 2017 ; Tao et al, 2019 ) reported the outcome which is also reported in at least one other study, and were included in the meta-analysis, and the results of other studies were described in term of outcomes. Selegiline treatment duration ranged from 2 weeks to 7 years.…”

Section: Resultsmentioning

confidence: 99%

“…Selegiline significantly improved UPDRS II and III score during an average of 2 years of follow-up, but not at 2 months (Dalrymple-Alford et al, 1995 ; Shoulson et al, 2002 ). Three RCTs reported the comparison between selegiline and the other active controls, showing no statistical difference among levodopa, bromocriptine, lisuride, entacapone and selegiline in improving UPDRS I and III score (Caraceni et al, 1992 ; Lyytinen et al, 2000 ; Caraceni and Musicco, 2001 ). UPDRS II score was significantly improved among patients treated with selegiline compared with patients treated with levodopa, bromocriptine, and lisuride (Caraceni et al, 1992 ).…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of selegiline for the treatment of Parkinson's disease: A systematic review and meta-analysis

Wang

Liu

et al. 2023

Front. Aging Neurosci.

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BackgroundDrug efficacy generally varies with different durations. There is no systematic review analyzing the effect of selegiline for Parkinson's disease (PD) on different treatment duration. This study aims to analyze how the efficacy and safety of selegiline changes for PD over time.MethodsPubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure and Wanfang Database were systematically retrieved for randomized controlled trials (RCTs) and observational studies of selegiline for PD. The search period was from inception to January 18th, 2022. The efficacy outcomes were measured by the mean change from baseline in the total and sub Unified Parkinson's Disease Rating Scale (UPDRS), Hamilton Depression Rating Scale (HAMD) and Webster Rating Scale (WRS) scores. The safety outcomes were measured by the proportion of participants having any adverse events overall and that in different system organ classes.ResultsAmong the 3,786 studies obtained, 27 RCTs and 11 observational studies met the inclusion criteria. Twenty-three studies reported an outcome which was also reported in at least one other study, and were included in meta-analyses. Compared with placebo, selegiline was found with a stronger reduction of total UPDRS score with increasing treatment duration [mean difference and 95% CIs in 1 month: −3.56 (−6.67, −0.45); 3 months: −3.32 (−3.75, −2.89); 6 months: −7.46 (−12.60, −2.32); 12 months: −5.07 (−6.74, −3.41); 48 months: −8.78 (−13.75, −3.80); 60 months: −11.06 (−16.19, −5.94)]. A similar trend was also found from the point estimates in UPDRS I, II, III, HAMD and WRS score. The results of observational studies on efficacy were not entirely consistent. As for safety, compared with placebo, selegiline had higher risk of incurring any adverse events [rate: 54.7% vs. 62.1%; odd ratio and 95% CIs: 1.58 (1.02, 2.44)], with the excess adverse events mainly manifested as neuropsychiatric disorders [26.7% vs. 31.6%; 1.36 (1.06, 1.75)] and no significant change over time. The statistically difference in overall adverse event between selegiline and active controls was not found.ConclusionSelegiline was effective in improving total UPDRS score with increasing treatment duration, and had a higher risk of incurring adverse events, especially the adverse events in the neuropsychiatric system.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: PROSPERO CRD42021233145.

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Pharmacotherapy of motor symptoms in early and mid-stage Parkinson’s disease: guideline “Parkinson’s disease” of the German Society of Neurology

Höllerhage,

Becktepe,

Classen

et al. 2024

J Neurol

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Background and objective There are multiple pharmacological treatment options for motor symptoms of Parkinson’s disease (PD). These comprise multiple drug classes which are approved for the condition, including levodopa, dopamine agonists, COMT inhibitors, MAO-B inhibitors, NMDA-receptor antagonists, anticholinergics, and others. Some of the drugs are approved for monotherapy and combination therapy while others are only approved as adjunctive therapy to levodopa. Furthermore, treatment for special treatment situations, e.g., rescue medication for off-phases, for tremor, treatment during pregnancy and breast feeding is discussed and recommendations are given with further details. Methods The recommendations were based on systematic literature reviews, drafted by expert teams, consented in online polls followed by online consensus meetings of the whole German Parkinson’s Guideline Group, and publicly released in November 2023. Results In the new S2k (i.e., consensus-based) guidelines, the pharmacotherapy of the motor symptoms of PD is discussed in five chapters. These comprise “Parkinson medication”, “Initial monotherapy”, “Early combination therapy”, “Fluctuations and dyskinesia”, and “Parkinsonian tremor”. Furthermore, there is a chapter for special treatment situations, including perioperative management, freezing of gait, and pregnancy and breastfeeding. Conclusion The recommendations for the pharmacotherapy of motor symptoms of PD have been updated. Newly available drugs have been added, while other drugs (e.g., ergoline dopamine agonists, anticholinergics, budipine) have been removed from the recommendations.

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Entacapone and selegiline with l-dopa in patients with Parkinson's disease: an interaction study

Cited by 8 publications

References 21 publications

The effect of Banisteriopsis caapi (B. caapi) on the motor deficits in the MPTP‐treated common marmoset model of Parkinson's disease

The effect of Banisteriopsis caapi (B. caapi) on the motor deficits in the MPTP‐treated common marmoset model of Parkinson's disease

Efficacy and safety of selegiline for the treatment of Parkinson's disease: A systematic review and meta-analysis

Pharmacotherapy of motor symptoms in early and mid-stage Parkinson’s disease: guideline “Parkinson’s disease” of the German Society of Neurology

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