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Selegiline (Anipryl)

Description

Selegiline, a monoamine oxidase inhibitor, was first discovered in Hungary during the 1960s. By the 1980s, it was used to treat Parkinson's disease, and that is still its primary use today. Selegiline does not have any anti-Parkinson effects on its own and needs to be taken in combination with levodopa/carbidopa. Selegiline has also been used to treat other medical conditions, such as depression, narcolepsy, schizophrenia and Alzheimer's disease.

Selegiline is a levorotatory acetylenic which is a derivative of phenethylamine. Selegiline is a white crystalline powder that is water soluble. Some of the brand names for this drug are Anipryl, Eldepryl, Emsam, L-deprenyl, and Zelapar.

Selegiline protects the dopamine cells in the brain from oxidative stress. It works by inhibiting the enzyme monoamine oxidase in the brain's nerve cells. Restriction of this enzyme causes dopamine levels to increase. Increased dopamine levels help to relieve the symptoms of Parkinson's disease. Research is being done to determine if Selegiline can also slow down the progression of Parkinson's disease.

In 2006, the Selegiline transdermal patch was approved for the treatment of mental depression. Selegiline also has anti-neurodegenerative and immune-system-boosting effects. Selegiline usage can increase the levels of tyrosine hydroxylase, cerebral nitric oxide, and also increase the production of key interleukins.

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Recommendations

The typical recommended dose of the oral drug in tablet form for adults is 5 mg, to be taken twice a day with meals. For the Selegiline oral disintegrating tablet, the recommended adult dose is 1.25 mg once a day. Sometimes the dosage is increased after six weeks. There usually aren't any beverage and food restrictions for doses of 10 mg or less. If a dose is missed it should be taken as soon as possible. Doubling up on a dose because of one has been missed is not recommended.

When taking Selegiline, it is important for individuals to let their physician know about any other health conditions they may have. It is also recommended they inform their physician about all medications they are taking. Certain prescriptions medications for relieving pain or depression can cause other health issues when taken with Selegiline.

It's important for all patients to stay in contact with their health care provider while they are taking Selegiline. Patients that are being treated with Selegiline for their depression also need to be closely monitored.

Side Effects

There are some serious side effects that may occur when taking Selegiline. Individuals that experience breathing problems, hives, swelling of the lips, tongue, throat or face need to get emergency help right way. Serious side effects include: confusion, severe headaches, blurred vision, chest pains, convulsions, numbness, weakness, fainting, speech or balance problems, severe nausea, vomiting, hallucinations and suicidal thoughts.

Some of the mild side effects that have been associated with Selegiline are: dry mouth, dizziness, muscle pain, rash, constipation and difficulty staying or falling asleep. It's very important for patients to let their physician know about any side effects they are experiencing.

Restrictions

Selegiline is not recommended for children, adolescents, pregnant women or elderly patients. There are several different kinds of medications that cannot be taken at the same time with Selegiline. Some antidepressants, such as Cymbalta and Lexapro can cause adverse side effects when used together with Selegiline. Pain medication like pethidine should not be taken with Selegiline because serious health problems may occur. Even non-prescription cough medicines need to be avoided. Some over-the-counter (OTC) medicines for flu, appetite control, allergy or pain can interfere with Selegiline.

Selegiline needs to be used with caution in individuals that have cardiovascular disease because the drug can cause hypertension, tachycardia, and arrhythmias. The Selegiline transdermal system hasn't been systematically evaluated for patients that have heart disease. Usage of this drug should be stopped at least ten days prior to any elective surgery that requires general anesthesia.

There are some beverage and food restrictions for individuals that are taking more than 10 mg of Selegiline per day. Alcoholic beverages should never be consumed when taking higher doses of this medication. Foods that are rich in tyramines like yogurt, smoked meats, and red wine should be avoided. Herbs, such as ginseng and St. John's wort, should not be used. Beverages or foods that contain high amounts of caffeine have to be eliminated from the patient's diet too. After stopping Selegiline these beverages and foods can continue to react with the drug when higher doses were taken.

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