title: Monoamine Oxidase B Inhibitors in Parkinson's Disease.
abstract: BACKGROUND
  Parkinson's disease (PD) is a neurodegenerative disorder with a prevalence increasing with age. Oxidative stress and glutamate toxicity are involved in its pathomechanism. There are still many unmet needs of PD patients, including the alleviation of motor fluctuations and dyskinesias, and the development of therapies with neuroprotective potential.
  
  
  OBJECTIVE
  To give an overview of the pharmacological properties, the efficacy and safety of the monoamine oxidase B (MAO-B) inhibitors in the treatment of PD, with special focus on the results of randomized clinical trials.
  
  
  METHODS
  A literature search was conducted in PubMed for 'PD treatment', 'MAO-B inhibitors', 'selegiline', 'rasagiline', 'safinamide' and 'clinical trials' with 'MAO-B inhibitors' in 'Parkinson' disease'.
  
  
  RESULTS
  MAO-B inhibitors have a favorable pharmacokinetic profile, improve the dopamine deficient state and may have neuroprotective properties. Safinamide exhibits an anti-glutamatergic effect as well. When applied as monotherapy, MAO-B inhibitors provide a modest, but significant improvement of motor function and delay the need for levodopa. Rasagiline and safinamide were proven safe and effective when added to a dopamine agonist in early PD. As add-on to levodopa, MAO-B inhibitors significantly reduced off-time and were comparable in efficacy to COMT inhibitors. Improvements were achieved as regards certain non-motor symptoms as well.
  
  
  CONCLUSIONS
  Due to the efficacy shown in clinical trials and their favorable side-effect profile, MAO-B inhibitors are valuable drugs in the treatment of PD. They are recommended as monotherapy in the early stages of the disease and as add-on therapy to levodopa in advanced PD.
authors.affiliation: Department of Neurology, University of Szeged, H-6725 Szeged, Semmelweis u. 6. Hungary.
authors.forename: Livia
authors.initials: L
authors.lastname: Dezsi
authors.affiliation: MTA-SZTE Neuroscience Research Group, H-6725 Szeged, Semmelweis u. 6. Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Vecsei
mesh_terms: D000818:Animals; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy* / Q000201:enzymology
chemical_list: D000978:Antiparkinson Agents; D008996:Monoamine Oxidase Inhibitors