Selegiline drug does not increase Parkinson's death rate

December 25, 2000

ST. PAUL, MN - Researchers have debated for years whether the drug selegiline increases the risk of death for Parkinson's patients even though others have suggested that the drug may slow the progression of the disease. A new study shows that there is no increased death rate for patients who use the drug in combination with levodopa, the most common drug for Parkinson's. The study is published in the December 26 issue of Neurology, the scientific journal of the American Academy of Neurology.

"This is exciting news because this drug is the first that showed even the possibility of slowing the course of this disease, not just treating its symptoms," said neurologist William Langston, MD, of The Parkinson's Institute in Sunnyvale, Calif., who co-authored an accompanying editorial on the study. "But when a study came out several years ago reporting that it raised the death rate, near-panic ensued. Even though there were criticisms of that study and other studies failed to confirm the original results, there was a chilling effect on the use of selegiline. This study should dispel any remaining doubts."

The study examined people newly diagnosed and receiving drugs for Parkinson's disease in the Tayside region of Scotland from 1989 to 1995. Those 97 cases were compared to 902 people from the community who did not have Parkinson's disease. The study looked at the death rates for people taking levodopa alone, selegiline alone, or selegiline in addition to other antiparkinsonian drugs, and compared the death rates in each of these groups with people who did not have Parkinson's disease.

Overall, those with Parkinson's were twice as likely to die during the study period than their healthy counterparts. But those patients who were taking selegiline in combination with levodopa were no more likely to die during the study than the people without Parkinson's. People taking levodopa alone had the highest death rate among the three treatment groups, according to study author Peter Donnan, PhD, of the University of Dundee in Dundee, Scotland.

Selegiline has been used as a treatment for Parkinson's for nearly 25 years, but excitement about the drug peaked in the mid-1980s when research suggested that it may have neuroprotective effects, thereby slowing the effects of the disease on the brain. But a later study raised doubts about that theory.

"The debate has been whether selegiline actually affects the progression of the disease or whether it just affects the symptoms," Langston said. "While proving that selegiline -- or any anti-parkinsonian drug -- is neuroprotective remains beyond our technical grasp, this study shows us that at the very least treating patients with selegiline and levodopa is not a bad thing, and in fact may be a very good thing."
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For more information contact: Kathy Stone (651) 695-2763 or kstone@aan.com

A neurologist is a medical doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system.

The American Academy of Neurology, an association of more than 17,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research.

For more information about the American Academy of Neurology, visit its Web site at www.aan.com. For online neurological health and wellness information, visit NeuroVista at www.aan.com/neurovista.

American Academy of Neurology

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