The effects of acute loading with levodopa and levodopa with selegiline on blood pressure and plasma norepinephrine levels in chronic Parkinson's disease patients.
OBJECTIVE
Contradictory possible cardiovascular side effects of selegiline have been reported. Therefore, we studied the effect of acute administration of selegiline with levodopa (LD) compared with LD alone, on blood pressure, pulse and norepinephrine (NE) plasma levels, during an orthostatic test on chronically treated Parkinson's disease patients (PDpts) and controls.


METHODS
Twelve PDpts treated with LD (group D), 12 PDpts treated with selegiline and LD (group S) and eight volunteers (CTRL) underwent the orthostatic test. Patients repeated the test twice, before and after acute loading with 125 mg LD (group D) and 125 mg LD +5 mg selegiline (group S).


RESULTS
Group S showed more episodes of postural hypotension (n = 10; two symptomatic) than group D (n = 4) and CTRL (n = 2), however not statistically significant. Plasma NE also rose significantly higher (P < 0.001) in group S.


CONCLUSIONS
PD patients treated with selegiline showed more orthostatism and higher plasma NE after submission to the orthostatic test. These findings may be relevant to explain its deleterious effect.
Stryjer
R
R
Department of Neurology, Assaf Harofeh Medical Center, Zerifin, Israel.
Klein
C
C
Treves
T A
TA
Rabey
J M
JM
D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood*; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology*; D011674:Pulse; D012146:Rest / Q000502:physiology; D012642:Selegiline / Q000008:administration & dosage*; D016683:Supine Position / Q000502:physiology
D000978:Antiparkinson Agents; D012642:Selegiline; D007980:Levodopa; D009638:Norepinephrine