Mucuna and Selegiline

[Farooqji]

Has any body experience the combination? Any adverse effect?

[Dee1980]

My dad is currently on both, well Mucuna and 'rasagaline' which is an MAO inhibiter same as selegiline. He hasn't had any side effects that we know about, but MAO inhibiters in themselves can cause side effects. He does say he feels off balance but he previously had dementia for the last few months and couldn't really tell us if that was an issue.

The thing to watch out for would be too much Mucuna causing too much dopamine build up, so, as with Levodopa, might need to keep an eye on Mucuna dosage if there are problems.

[Farooqji in reply to Dee1980]

thanks for sharing

[hercules957]

I got serious nausea when I introduced selegiline to Mucuna.

[Greenday in reply to hercules957]

Could you post which mucuna product?

[hercules957 in reply to Greenday]

Mucuna Pruriens 40% manufactured by Signature Supplements in Canada.

[Greenday]

Rasagiline is newer to Selegiline selective MAO-B inhibitor with possibly less side effects with the added benefit of a neuroprotective effect as some studies suggest,. I wonder why some doctors still prescribe Selegiline which older drug and possibly more likely to produce side effects compared to Rasagiline .

" Selegiline is a propargyl amphetamine derivative that undergoes extensive first-pass metabolism to L-methamphetamine and L-amphetamine. Rasagiline's major metabolite is amioindan, which has no amphetaminelike properties. Selegiline has been reviewed looking for neuroprotection, but studies have been unable to come to a definite positive neuroprotection conclusion. Proponents of rasagiline's neuroprotective effects also point to clinical studies in humans that demonstrate delayed and reduced need for future use of levodopa." ncbi.nlm.nih.gov/pubmed/212...

Possibly the amphetamine derivatives of Selegiline (but not Rasagiline) may cause nausea or the type and dosage of Mucuna extract used or the combination of all those. According to current studies plain mucuna powder with a levodopa concentration of 4-6% produce less side effects such as nausea compared to levodopa alone. However many Mucuna products-extracts in the market advertise as 15-98% levodopa concentration. Those products may lack the beneficial properties of the whole mucuna powder. High concentrations of Levodopa or high doses of mucuna >15g may likely induce nausea. ncbi.nlm.nih.gov/pmc/articl...

The Zandopa mucuna manufacturer cautions to stop MAO inhibitors 2 weeks before taking mucuna. However there is no mention whether it includes both selective and non selective MAO inhibitors. zanduayurveda.com/products/... . I've contacted Zandopa to ask why it excludes newer MAO inhibitors such as Rasagiline and didn't receive any reply.

Older non-selective MAO inhibitors interact with many drugs and supplements and more likely to produce side effects. However I couldn't find any reliable source why mucuna is contradicted with rasagiline or selegiline. A reason may be the unknown properties of mucuna which mucuna attributes its increased bioavailabilty.

Plain mucuna powder is superior to levodopa alone.Yet-to-be-discovered compounds such as decarboxylase or MAO inhibitors in mucuna may explain the increased bioavailability to mucuna over levodopa. If this hypothesis is valid, adding other inhibitors may increase the risk of side effects.

[hercules957]

Interesting. I took Selegiline with Sinemet before Mucuna and I had no side effect. Your metabolization explanation might be valid or it might be a reaction to other element of Mucuna. Or it might just be me. We are all different in how we respond to meds or progress.

[Greenday in reply to hercules957]

Ok, The mucuna powder you've been taking it's an extract with a high levodopa concentration and possibly lack the beneficial properties of the whole mucuna powder. Levodopa is well known to induce nausea and high concentration extracts are very likely to cause nausea. All human studies on mucuna are based on whole mucuna powder with 4-6% levodopa concentration. This concentration of levodopa is less likely to induce nausea unless taken in big amounts ncbi.nlm.nih.gov/pmc/articl...

[hercules957 in reply to Greenday]

Possibly, but when taking Mucuna without Selegiline, I do not experience nausea. I need a high amount of levodopa to affect my symptoms, a lesser concentration would require me to take very large amount to get the effect desired.

[Greenday in reply to hercules957]

I suggest you read the following human study ncbi.nlm.nih.gov/pmc/articl...

The same amount of levodopa in the whole mucuna powder offers superior bioavailability and less likely to cause side effects compared to the same amount of levodopa alone. Therefore you need to take almost 2 times less levodopa in the whole mucuna powder to achieve similar results to levodopa alone, with the added benefit of less side effects. The maximum amount of mucuna taken in the mucuna studies is usually 30g, but most need to take less than 15g depending on the severity of the disease.

No human study exists that shows mucuna extracts offer any benefit over levodopa alone.

Probably there is too much levodopa in your blood and adding Selegiline prolongs its duration by slowing the process of breaking down, therefore increasing the possibility of side effects. As someone in this thread has already suggested, you should take less levodopa when taking with selegiline. This same applies with PD prescription drugs as well, those prescribed MAO inhibitors & dopamine agonists may need to take less levodopa compared to taking the levodopa drug alone. Also suggest to talk with your doctor whether you need to replace Selegiline with Rasagiline with the possible added benefit of neuroprotection.

I personally would stick with pure mucuna powder (4-6% levodopa) or a proprietary mucuna product such as Zandopa (3.33% levodopa) which efficacy have been verified in multiple human studies, anything else may be devoid of the mucuna's beneficial properties.

Of course I really appreciate for bringing up this matter to attention as there are no official guidelines regarding the interaction of mucuna with other PD drugs.

[Farooqji in reply to Greenday]

thanks for taking time and sharing details. I have asked Dr Michael Okun and he replied that there is no harm in taking mucuna and selegiline together

[Greenday in reply to Farooqji]

Thank you for letting us know. Does this apply for Rasagiline as well?

[Farooqji in reply to Greenday]

let me check with Dr Okun and I will revert back

[Greenday in reply to Farooqji]

Thanks a lot, it would make a difference to all of us taking this combination together

[Farooqji in reply to Greenday]

Michael Okun

2:31 AM (10 hours ago)

to me

No problem with rasagiline

[Greenday in reply to Farooqji]

Thank you very much and Dr Okun for clarifying that.

[hercules957 in reply to Greenday]

Good points Greenday. The study states that the mucuna powder used was from roasted seeds obtained without any pharmacologic processing. You are correct, when taking Selegiline we should need less L-Dopa, whatever form we get it from. I had reduced it, probably not enough.