An add-on study of selegiline to Madopar in the treatment of parkinsonian patients with dose-related fluctuations: comparison between Jumexal and Parkryl.
BACKGROUND
To improve dose-related fluctuations in patients with Parkinson's disease, the efficacy of selegiline, a selective inhibitor of monoamine oxidase B, was determined.


METHODS
Twenty parkinsonian patients were selected for a short-term, single-blind, cross-over trial. Each patient received one of the two brands of selegiline, Parkryl (Mei-Shih), 10 mg per day as an adjunct to Madopar. After a 6-week treatment period and a 4-week wash-out period, the treatment was switched to the other brand of selegiline, Jumexal (Labatec), for another 6 weeks.


RESULTS
Five patients dropped out of the study because of the development of intolerable dyskinesia, hallucination or agitation. The 15 patients that completed the study made a mild improvement in the total motor scores of the on-period during both treatments of Parkryl (p < 0.01) and of Jumexal (p < 0.05). The recorded daily off-time decreased from 37.8% to 20.7% in the Parkryl group (p < 0.01), and to 21.0% in the Jumexal group (p < 0.01).


CONCLUSIONS
Selegiline, as an adjunct therapy to Madopar, has a moderate effect in prolonging the duration of on-time in parkinsonian patients with dose-related fluctuations. Jumexal seemed to produce no greater effect than Parkryl.
Shan
D E
DE
Neurology, Neurological Institute, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Yeh
S I
SI
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D001545:Benserazide / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008875:Middle Aged; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D009068:Movement / Q000187:drug effects*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology; D012642:Selegiline / Q000627:therapeutic use*; D016037:Single-Blind Method
D000978:Antiparkinson Agents; D004338:Drug Combinations; D004791:Enzyme Inhibitors; D008996:Monoamine Oxidase Inhibitors; C005177:benserazide, levodopa drug combination; D012642:Selegiline; D007980:Levodopa; D001545:Benserazide