Selegiline in de novo parkinsonian patients: the Finnish study.
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 long-term 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.
Myllylä
V V
VV
Department of Neurology, University of Oulu, Finland.
Sotaniemi
K A
KA
Vuorinen
J A
JA
Heinonen
E H
EH
D000203:Activities of Daily Living; D000368:Aged; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000188:drug therapy*; D012642:Selegiline / Q000627:therapeutic use*
D012642:Selegiline; D007980:Levodopa