Neurology Medical News about Monoamine Oxidase Inhibitors Parkinson Disease Dopamine Agents

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Monoamine oxidase B inhibitors versus other dopaminergic agents in early Parkinson's disease
Cochrane Reviews, 10/09/09

Caslake R R et al. – Currently, there are several different treatments available for people with newly diagnosed Parkinson's including levodopa which is converted into dopamine in the brain, dopamine agonists which mimic the action of dopamine, and monoamine oxidase B (MAO–B) inhibitors (selegiline or rasagiline) which reduce the breakdown of dopamine in the brain. Each of these types of drugs has theoretical advantages and disadvantages. For example, although a very good treatment, levodopa can cause involuntary movements (dyskinesia), painful cramps (dystonia) and a shortened response to each dose (motor fluctuations) after a while, whilst MAO–B inhibitors and dopamine agonists may reduce the risk of these complications but are not so good at improving the symptoms of Parkinson's...Unfortunately the authors only identified two trials (593 patients) so there was only limited evidence. MAO–B inhibitors are one option for the early treatment of PD although they have weaker symptomatic effects than levodopa and dopamine agonists. They may reduce the rate of motor fluctuations compared with initial levodopa therapy and may have fewer significant adverse effects than the older agonists but data are too few to provide reliable conclusions.

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