Selegiline may be one of the best treatments for early Parkinson’s disease
The results of a meta-analysis published online on August 12, 2004 in the British Medical Journal (www.bmj.com) found that the monoamine oxidase B inhibitor (MAOBI) selegiline (also known as deprenyl) could be one of the most effective therapies for patients with early Parkinson’s disease. Selegiline emerged as a novel treatment for the disease in the 1980s, but its use fell out of favor following the publication of a study in 1995 that linked the drug with increased mortality; a finding which the authors of the current analysis attribute to chance.

The meta-analysis included 17 trials involving 3,525 patients with Parkinson’s disease. Thirteen trials compared selegiline with a placebo or with levodopa, a drug that most patients with Parkinson’s disease eventually need. The four remaining trials involved other MAOBIs. Some of the trials compared the effects of a combination of a MAOBI and levodopa to a placebo with or without levodopa.

The researchers, from the University of Birmingham in England, found that participants who received MAOBIs had significantly less disability compared to those who received placebos. Patients on MAOBIs also experienced a delay in the need for levodopa, and those using the drug were less likely to require increased amounts. Additionally, those receiving MAOBIs had a reduced risk of developing motor fluctations. No substantial side effects or increased mortality were found in those taking MAOBIs.

This meta-analysis is the first to evaluate MAOBIs as a drug class for early Parkinson’s disease. The authors conclude, “Our review provides no evidence that mortality is increased by selegiline and suggests that this inexpensive drug could be one of the most clinically effective and cost effective treatments available for early Parkinson’s disease.”

Parkinson’s disease
Although there is no cure for Parkinson's disease, the primary medical treatment consists of providing a drug called L-dopa (levodopa), which can be converted in the brain to dopamine (Clayman 1989). In addition, there are a variety of dopamine-sparing drugs and dopamine receptor-stimulating drugs. However, treatment with these types of drugs is not always effective, particularly in advanced conditions.

The most commonly used levodopa drug is Sinemet. Sinemet contains the decarboxylase inhibitor carbidopa to prevent deactivation of L-dopa before it reaches the brain.

Eldepryl (deprenyl) is a selective monoamine oxidase inhibitor (MAOI) that slows the breakdown of dopamine in the brain, thereby initially reducing the need for levodopa by up to 30%. This effect diminishes with time. Therefore, in the early stages of Parkinson's disease, Eldepryl alone may alleviate symptoms. Eldepryl is also used in combination with Sinemet, particularly when Sinemet no longer seems to be working well. At this stage, Eldepryl has no effect when taken by itself and works only in combination with Sinemet (PDR 2002). Deprenyl and selegiline hydrochloride are generic names for Eldepryl.

There is some evidence that the generic drug deprenyl has a protective effect on brain cells when compared to levodopa, which appears to lead to more rapid deterioration (Mytilineou et al. 1993; Tipton 1994; Pardo et al. 1995; Wu et al. 1995; Liou et al. 2001). While deprenyl has received some bad publicity in recent years, it is now clear that deprenyl is safe in combination with levodopa.

Supplementation with nutrients has reported benefits for persons with Parkinson's disease. These supplements include amino acids, antioxidants, coenzyme Q10, melatonin, folic acid, acetyl-L-carnitine, octacosanol, phosphatidylserine, NADH, and the European drug Hydergine (Snider 1984; Yapa 1992; Mizuta et al. 1993; Schulz et al. 1995; 1996; Shults et al. 1997; 1998; 1999; Beal et al. 1998; Golbe et al. 1998; Sakagami et al. 1998; Seitz et al. 1998; Beal 1999; Jimenez-Jimenez et al. 2000; Kidd 2000; Nadlinger et al. 2001; Roghani et al 2001; Ross 2001; Tan et al. 2001; Zisapel 2001; Antolin et al. 2002; Chen et al. 2002; Duan et al. 2002).

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Life Extension Magazine August 2004

Innovative research and applications for coQ10

In a study of Parkinson’s disease patients, 360 mg a day of coQ10 was administered for only four weeks, producing a mild symptomatic improvement compared to placebo. More important, an established clinical test to measure Parkinson’s symptom function showed significantly better improvement of performance in the coQ10-supplemented patients compared with the placebo group.

This new study helped to corroborate a report last year that Parkinson’s patients consuming 1200 mg a day of coQ10 showed a 44% reduction in the decline of motor skills, movement, and mental function compared to the placebo group. Those receiving this high-dose coQ10 also demonstrated an improved ability to perform daily living tasks. This 16-month study was remarkable in that coQ10 slowed the progression of the disease, something that Parkinson’s drugs do not do.

Questions? Comments? Send them to ddye@lifeextension.com or call 954 766 8433 extension 7716.

For longer life,

Dayna Dye
Editor, Life Extension Update
ddye@lifeextension.com
LifeExtension.com
1100 West Commercial Boulevard
Fort Lauderdale FL 33309
954 766 8433 extension 7716

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