Patients taking selegiline may have received more levodopa than necessary

doi:10.1136/bmj.312.7032.702a

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C Warren Olanow*,
James H Godbold**,
William Koller*

Professor, department of neurology Research associate professor, department of community medicine Mount Sinai Medical Center, Box 1137, New York, NY 10029, USA
Professor Department of Neurology, University of Kansas, Kansas City, KS 66160, USA

EDITOR,—The Parkinson's Disease Research Group reports a 60% increase in mortality over five years in patients with Parkinson's disease taking levodopa and selegiline compared with those taking levodopa alone.1 This is the first report of increased mortality with selegiline and contrasts with our experience.2 We performed a prospective double blind study in 101 comparable patients with Parkinson's disease. They were randomly assigned to receive selegiline or placebo plus levodopa or bromocriptine. After five years only eight deaths had occurred (five in patients taking placebo and three in patients taking selegiline).

We have several concerns with …