Selegiline

[Giovi1960]

Is it safe to take selegiline with carbo levodopa?

[park_bear]

yes. They work together synergistically.

[Giovi1960 in reply to park_bear]

Thank you for the reply . Regards.

[grower]

I've been taking the two for four years, seems fine, at least no side effects that I notice

[Giovi1960 in reply to grower]

Thank you, this relieves me. Regards

[wifeofparky]

my husband took both

[Giovi1960 in reply to wifeofparky]

Thanks for the reply. Regards

[BlueHawaii]

I hope it is ok. I have been taking both for several years.

[Giovi1960 in reply to BlueHawaii]

☺ I hope too! Best wishes

[HugoRipanykhazov]

Interesting point: When my doc prescribed me Selegeline, he added the specific proviso that he wound call the pharmacy and make peace with them on the adverse warnings that the pharmacist was bound to raise because there IS some major clash between the two.

like others who have responded, I saw no ill effects and took the two for a couple of years until I formed the opinion that the Selegelene was doing nothing and stopped.

[Giovi1960 in reply to HugoRipanykhazov]

Thank you for the information. My neurologist just added selegiline and I am really trying not to take too many meds. He said it would make the effect of c/l last longer and also prevent me from falling asleep after taking the c/l.

[sharoncrayn in reply to HugoRipanykhazov]

Hugo,

here is the probable reason for the pharmacist's concern:

Dr. Barry Snow (NZ) wrote an article (1999-non peer reviewed) which suggested selegiline had no effect, neuroprotective or otherwise. He based his conclusion on a DATATOP study which was confusing in its terminology and its use of selegiline even though that study clearly states the opposite of Snow ("We conclude from these preliminary results that the use of deprenyl (10 mg per day) delays the onset of disability associated with early, otherwise untreated cases of Parkinson's disease.")

Snow does admit: "Thus for patients with motor fluctuations and without dementia or falls, selegiline may be both beneficial and safe."

He also discusses an earlier 1995 PDRG (UK) report on mortality associated with selegiline. This paper was heavily criticized and deemed worthless, so why he even discussed it or alluded to it is beyond me. Yet, many physicians in the UK, AU, and NZ still believe its conclusions after all these years and criticisms. As do many pharmacists.

Unfortunately, Dr. Snow had no business writing this article without much more substantive proof for his theories.

Sharon

[Giovi1960 in reply to sharoncrayn]

Interesting, thanks Sharon.

[HugoRipanykhazov in reply to sharoncrayn]

No, there was talk of an adverse reaction between the two drugs, the effects of which had permeated through to the pharmacist community. My doctors were saying they didn't believe it and would take responsibility for, in effect guaranteeing that I wouldnt suffer any such adverse reaction.

So I took selegilene and sinemet together for a few years while I had what my doctors called very mild Parkinsons which wasn't getting any worse. When I went off it, a few more years passed where my symptoms didn't get any worse until recently, when my PD has become very slightly more marked. I suppose it is arguable that I should go back on it if there is ANY research showing that it does stem regression? No one mentioned staying off any foodstuffs and I certainly didn't, - without any ill effects. I certainly would have noticed if I had been told to stay off unpasteurised cheese and cured meats!

I didn't want to rubbish the drug on a public forum because I have no real medical training and dont really know what I am talking about and there are people here who are on it. Including those in England on the NHS where gigantic numbers of doctors who know a whole lot more about PD than I do regard it as the standard treatment!

[sharoncrayn in reply to HugoRipanykhazov]

"I didn't want to rubbish the drug on a public forum because I have no real medical training and dont really know what I am talking about and there are people here who are on it."

Well said.

Sharon

[Zardoz]

I take generic sinemet along with selegiline. Selegiline limited to 10 mg in two 5 mg doses.

You need to avoid certain foods containing tyramine, like aged cheese and cured meats.

Selegiline is also known as deprenyl, and a search of "deprenyl" at lifeextension.com will yield much favorable info about that MAO inhibitor.

[Giovi1960 in reply to Zardoz]

Thanks, great information. I'll look into it. Regards

[Mimer in reply to Zardoz]

I have got the information that the combination of tyramine and selegiline do not give the "cheese effect" and raise the blood pressure as long as the dosage is for selective mao-b inhibition (dopamine break down). You need to be careful with tyranine though on higher doses which makes selegiline a general mao inhibitor or if combined with other mao inhibitor.

I am on 10 mg selegiline as mono therapy myself and I try to excercise with fast walking and high cadence cykling to manage my PD. I guess monotherapy with selegiline is what John Pepper adviced you to try.

[sharoncrayn in reply to Mimer]

"You need to be careful with tyranine though on higher doses which makes selegiline a general mao inhibitor or if combined with other mao inhibitor."

Basically drawn from rat studies where the chronic use of selegiline decreased "tyrosine" activity.

But, but, but(!) the reduce tyrosine activity is not associated with a negative change in dopaminergic receptors.

Sharon

[Mimer in reply to sharoncrayn]

Just to clarify the quoted text. Higher doses of selegiline makes it block also mao-a. If you are on that dosage level or are combinimg with other mao inhibitor, especially based on moklobemid, the manufacturer of the brand Eldepryl has warning text about tyramine. For mao-b inhibition they do not. My MD and pharmacept said the same thing .

I can not comment how they came to that conclusion, since I do not know. But I assumed that it would be reported clinical data to back it up, since it should be pretty forward to follow up increased blood pressure during selegiline medication.

[sharoncrayn in reply to Mimer]

You would have to over dose (>30-40 mgs per day) selegiline on a chronic, long term basis. (same goes for many antidepressants) and eat a diet high in tyramine foods to obtain a dangerous spike in BP.

If someone is at that extreme level, avoid beer, old cheese, any processed meats like hot dogs, red wine, and chocolate. That is about the extent of avoidance.

Of course, some web sites claim any amount of tyramine foods are dangerous with any MAO-i in any amount, or even alone. In that case, if you believe it, you would go on a very restricted, non-tyramine diet eating just fresh meat, poultry, and fish. Almost nothing else except in very small amounts.

Realistically, at 10 mgs. per day selegiline has no (or minimal) tyramine effect.

Have your doctor/pharma look at Heinonen's study.

"Selegiline (deprenyl), a selective, irreversible inhibitor of monoamine oxidase type B (MAO-B) is widely used in the treatment of Parkinson's disease. As the first MAO-B inhibitor approved for the treatment of Parkinson's disease, concerns were raised about the safety of the drug based on the adverse effect profiles of older, nonselective MAO inhibitors. Unlike the nonselective MAO inhibitors, selegiline does not significantly potentiate tyramine-induced hypertension (the 'cheese effect') at the dosages (5 to 10 mg daily) used for the treatment of Parkinson's disease. "

Sharon

[Giovi1960 in reply to sharoncrayn]

Thank you, Sharon. This helps a lot. Regards

[JohnPepper]

Yes. But rather take it on its own and start doing fast walking and start getting better. Google my name and fet hold of me.

[Giovi1960 in reply to JohnPepper]

Hello John,

Do you mean take them separately, like an hour apart for example?

Thanks