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BMJ 2004;329 (11 September), doi:10.1136/bmj.329.7466.0-h
| The first 150 words of the full text of this article appear below. |
Some drugs are like weapons of mass destruction: often heard about but seldom seen. Selegiline, a monoamine oxidase type B inhibitor, was hailed in the 1980s as a drug that might alter the clinical course of idiopathic Parkinson's diseaseand not just relieve symptoms (p 581). A research paper published in the BMJ in 1995 (bmj.com/cgi/content/full/311/7020/1602) curbed that optimism by indicating that people taking selegiline and levodopa had a higher risk of death than those taking levodopa alone. Now this week's issue carries a meta-analysis of 17 trials comparing monoamine oxidase type B inhibitors with placebo and finds this class of drug improves symptoms, delays the use of levodopa, and lower doses can be used once levodopa is required (p 593).
Reclaiming older, cheaper drugs on the basis of sound evidence has become fashionable and the ALLHAT trial signalled a preference for thiazide diuretics over
Kamran Abbasi, acting editor
(kabbasi@bmj.com)
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