A successful switch from rasagiline to safinamide in a 49-year-old female with early-onset Parkinson's disease: a case report and review of literature.

There is a significant clinical challenge in the decision-making process when transitioning between monoamine oxidase-B inhibitors due to the sparse literature and lack of established guidelines for those trying to find the balance between risk for serious drug adverse effects and symptom exacerbation in Parkinson's disease. This case report and literature review is motivated by the limited body of evidence and conflicting recommendations regarding safe and effective management of such a switch. We discuss the trade-off between avoiding possible life-threatening complications such as serotonin syndrome and hypertensive crisis, while at the same time aiming for minimal washout period to minimize motor symptom exacerbation. The case of a 49 year-old female patient with early-onset Parkinson's disease who was transitioned from 1 mg rasagiline to 50 mg safinamide with a three-day washout period is described; afterwards, we review the relevant literature and current recommendations. We believe this paper will be valuable to clinicians and researchers managing such scenarios, and perhaps motivate further larger sample size studies, or help inform best practices in the treatment of Parkinson's disease.