Mortality associated with selegiline in Parkinson's disease. What do the available data mean?
A recent study by the Parkinson's Disease Research Group of the United Kingdom revealed higher mortality in patients with Parkinson's disease who were treated with selegiline (deprenyl) compared with those who were not. In this article, the methodological limitations of the UK study are discussed. Although several problems exist with this study, the mortality rate was correct, since the data were obtained from a verifiable source. The question then is whether or not the higher mortality rate can be ascribed to selegiline. It is difficult to find answers to this question in the study data, and we will have to wait for the study authors' final report. No other studies have reported higher mortality with selegiline. However, when prescribing selegiline in patients with early-stage Parkinson's disease, it is important to provide them with all the available information so that treatment decisions can be made jointly. Meanwhile, the best indication for selegiline appears to be motor fluctuations in patients with moderately advanced Parkinson's disease.
Mizuno
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Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
Kondo
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D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008996:Monoamine Oxidase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018696:Neuroprotective Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D010300:Parkinson Disease / Q000188:drug therapy / Q000401:mortality*; D018579:Patient Selection; D011446:Prospective Studies; D012107:Research Design / Q000592:standards; D012642:Selegiline / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006113:United Kingdom
D000978:Antiparkinson Agents; D008996:Monoamine Oxidase Inhibitors; D018696:Neuroprotective Agents; D012642:Selegiline; D007980:Levodopa