BMJ  2004;329:581-582 (11 September), doi:10.1136/bmj.329.7466.581

Editorial

Using monoamine oxidase type B inhibitors in Parkinson's disease

They are effective and safe, at least when used alone

The first 150 words of the full text of this article appear below.

Despite the growth in new drugs for the treatment of idiopathic Parkinson's disease, high quality evidence from randomised controlled trials to guide clinicians on choosing the most appropriate therapy is scarce. Monoamine oxidase type B inhibitors (MAOBIs) have been available for about 30 years. Their popularity was boosted in the 1980s when researchers proposed that they may have a neuroprotective effect and hence alter the natural history of disease rather than merely provide symptomatic relief. Subsequently one report of increased mortality in patients given selegiline with levodopa dented this popularity.1 In this issue, Ives et al provide us with a useful summary of the trials on MAOBIs for the treatment of Parkinson's disease (p 593).2

Of the 17 trials, most are short term studies—only seven have follow up data of over 18 months. In addition, most of the trials compare a MAOBI with placebo. These trials show that . . . [Full text of this article]

Yoav Ben-Shlomo, senior lecturer

Department of Social Medicine, University of Bristol, Bristol BS8 2PR (Y.Ben-Shlomo@bristol.ac.uk)

Kailash Bhatia, reader in clinical neurology

Sobell Department of Movement Neuroscience, Institute of Neurology, London WC1N 3BG (kbhatia@ion.ucl.ac.uk)


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