Print

Print


I received an error message on my first posting.
Forgive me if this gets posted twice. I read the
abstract and an editorial on thee selegiline
study in the Dec. 16 1995 issue of the British
Medical Journal. I was pretty confused by the
results and would like to hear what others think.
You can access portions of this journal on the
Internet at http://www.bmj.com/bmj/index.html
The complete article is not available on-line,
only the abstract, and the editorial.
How much weight do you think this study should
be given? As someone else said, it is probably
only a matter of time, that another article will
appear refuting these results, but it does raise
some serious doubts.
Over 500 patients from 93 different hospitals in
the United Kingdom with early PD were studied
over 5 years. One group was taking only levodopa,
the second group was on levodopa and selegiline
(eldepryl). The mortaality rate of the selegiline
group was almost 60% higher than the levodopa only
group. No information was given on the number of
deaths, the ages of the patients who died, or
the causes of death. How can we evaluate these
findings?
Also the study conclued that the use of selegeline
with levodopa "seemed to confer no clinical benefit."
Yet it also reported that "During the trial the dose
of levodopa required to produce optimum motor
controll steadily increased in arm 1 (levodopa only
group) (median daily dose 375 mg at 1 year and 625
mg at 4 years), but the median dose in arm 2 (levodopa
and selegiline) did not change (375 mg)." Isn't this
a clinical benefit?
The editorial came out strongly against the use of
selegiline and called for more studies to determine
if long term use is causually related to the in-
creased mortality reported in the study. For those
of us presently taking eldepryl, what do you think
we should do in the meantime?
Linda Herman
[log in to unmask]