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Gail thank you for asking this question.I have heard two outstanding neuros take oppsosing sides of the usefulness of Eldepryl. What was behind your inital curiosity of the discontinuance of the drug? I am wanting to follow the path ofs ome of thte other list members and begin reducing my intake of some of the meds. This desire is based on several points. First andformost , i seem to be afflictetd with a milder set of symptoms then many PWP that i have met..Dx'd since '92 my symptoms have not increased all the dramaticcally, i have used a scale and know w/o a doubt i have progressed downward monthly since '92. I think comparing charts of progression withothers PWP's mine would not appear as steep but rather more gradal in decline. Secondly, If some others have made the leap of ffaith and left their meds in the cabinets i am wiling to try it. Especially, if the long term result of some of the Rx prima donna's is suspect , which course of action might be worse.. Thirdsly, i will notchange any routines until i have doen copious amounts of reseach on boht sides of the issue and consider eqeually who is saying what?? ----- Original Message ----- From: "Gail Vass" <[log in to unmask]> To: <[log in to unmask]> Sent: Wednesday, May 01, 2002 3:42 PM Subject: Re: When discontinuing Eldepryl [ Selegiline ]... > Diana and George, > > Thanks for sharing your experiences with me. I have > collected some information on withdrawal patterns for > people on Eldepryl and find reactions as varied as > peoples response to anything else these days. > > This is some of what I've found in the list archives and > on the internet : > > http://www.medsafe.govt.nz/Profs/PUarticles/selegiline.htm > > "Selegiline may smooth muscle fluctuations. > ..... The inhibition of levodopa metabolism by > selegiline can effectively smooth out > predictable motor fluctuations in some patients. " > > "For patients who are already taking selegiline, I personally > do not routinely stop the medication. Some patients > experience a feeling of wellbeing on selegiline, and they > may experience withdrawal symptoms on stopping the > drug. Many patients taking selegiline are troubled by insomnia; > in these patients, I stop selegiline therapy." > > ============ > Slow recovery of human brain MAO B after L-deprenyl (Selegeline) withdrawal. > Synapse 1994 Oct;18(2):86-93 > L-Deprenyl (Selegeline) is an enzyme-activated irreversible inhibitor of monoamine > oxidase B . It is used to treat Parkinson's disease at a dose of > 5 mg twice a day. Since enzyme inhibition is irreversible, the recovery of > functional enzyme activity after withdrawal from L-deprenyl requires the synthesis > of new enzyme. We have measured a 40 day half-time for brain > MAO B synthesis in Parkinson's disease and in normal subjects after withdrawal from > L-deprenyl. This is the first measurement of the synthesis > rate of a specific protein in the living human brain. " > ========================================== > > http://www.parkinsons-information-exchange-network-online.com/drugdb/120.htm l > > "...selegiline caused slight improvement in motor performance > at the start of therapy and * worsening at its discontinuance; " > > " Selegiline doses of 10 mg/day block essentially all the MAO-B > in the adult brain. Selegiline's duration of action depends on the > time required to regenerate MAO type B. At higher selegiline doses > (e.g., 20-40 mg/day), brain MAO is blocked nonselectively, predisposing patients to > the risks of traditional MAOIs that block MOA type A (e.g., hypertension). Like > phenelzine, the effects of selegiline are cumulative, > with beneficial effects seen in a few days to several months. " > > "Pharmacokinetics: Selegiline is administered orally and is readily > absorbed from the GI tract and crosses the blood/brain barrier. Peak > serum concentrations are found in 0.5-2 hours. The drug is rapidly and completely > metabolized to three active derivatives with the following > half-lives: > N-desmethyldeprenyl, 2 hours; > 1-amphetamine, 17.7 hours; and > 1-methamphetamine, 20.5 hours. > Selegiline is eliminated slowly by the kidneys; about 45% of a single > 10 mg dose is eliminated in the urine as the three active metabolites > in 48 hours." > > ====================================================== > "What do I need to watch for while I take selegiline? > "Visit your doctor for regular checks on your progress. > It can take up to 4 weeks to see the full effects of selegiline. > * Do not suddenly stop taking your medicine; this may make your > condition worse or give you withdrawal symptoms.* > Ask your doctor for advice about gradually reducing your dosage. > Even after you stop taking selegiline the effects can last for at least > two weeks. " > ====================================================== > > http://www.parkinsons-information-exchange-network-online.com/archive/105.ht ml > > "Eldepryl (selegiline) is a monoamine oxidase type B inhibitor..." > > Monoamine oxidase is an enzyme used by the brain to metabolize, > or break down, dopamine. > > * Eldepryl often prolongs the effects of levodopa > therapy by prolonging dopamine action in the brain. * > > [My conclusion is that when you stop taking Eldepryl, you probably > will need more Sinemet to achieve the same level of symtomatic > control if you have been on it for a long time.] > =============== > > Brian Collins, a list member had posted: > > "The neuros are now grappling with the question of whether Selegeline > should be discontinued. * Some of the long-term takers have reported quite > severe withdrawal symptoms and are continuing to take it because of that." > =============== > Gradual withdrawal [of most drugs] is recommended to prevent acute return > of parkinsonian symptoms. > > Any other information and personal experiences will be appreciated. > > Gail Vass, R.N. > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: mailto:[log in to unmask] > In the body of the message put: signoff parkinsn ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn