Trial reportJournal of neurology, neurosurgery, and psychiatry1997
Autonomic effects of selegiline: possible cardiovascular toxicity in Parkinson's disease.
Trial report in Journal of neurology, neurosurgery, and psychiatry, 1997. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 109 citations in OpenAlex.
- Investigation by Parkinson's Disease Research Group of United Kingdom into excess mortality seen with combined levodopa and selegiline treatment in patients with early, mild Parkinson's disease: further results of randomised trial and confidential inquiry.BMJ (Clinical research ed.) · 1998Trial
- Catecholaminergic storm and extreme blood pressure lability induced by combined levodopa/benserazide, selegiline, and piribedil in Parkinson's disease: a case report.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Safety comparisons among monoamine oxidase inhibitors against Parkinson's disease using FDA adverse event reporting system.Scientific reports · 2023Article
- Monoamine Oxidase-B Inhibitors for the Treatment of Parkinson's Disease: Past, Present, and Future.Journal of Parkinson's disease · 2022Review
- Drug-Related Orthostatic Hypotension: Beyond Anti-Hypertensive Medications.Drugs & aging · 2020Review
- Safety and Tolerability of Pharmacotherapies for Parkinson's Disease in Geriatric Patients.Drugs & aging · 2019Review
- Inhibitors of MAO-B and COMT: their effects on brain dopamine levels and uses in Parkinson's disease.Journal of neural transmission (Vienna, Austria : 1996) · 2019Review
- Efficacy and safety of rasagiline in Chinese patients with early Parkinson's disease: a randomized, double-blind, parallel, placebo-controlled, fixed-dose study.Translational neurodegeneration · 2018Article
- Review
- Inhibitors of MAO-A and MAO-B in Psychiatry and Neurology.Frontiers in pharmacology · 2016Review
- The management of orthostatic hypotension in Parkinson's disease.Frontiers in neurology · 2013Article
- Piecing together the puzzle of progression and mortality in Parkinson's disease.British journal of clinical pharmacology · 2012Article
- Disease progress and response to treatment as predictors of survival, disability, cognitive impairment and depression in Parkinson's disease.British journal of clinical pharmacology · 2012Article
- Controversies in neurology: why monoamine oxidase B inhibitors could be a good choice for the initial treatment of Parkinson's disease.BMC neurology · 2011Article
- Antipsychotic pharmacotherapy and orthostatic hypotension: identification and management.CNS drugs · 2011Review
- MAO-inhibitors in Parkinson's Disease.Experimental neurobiology · 2011Article
- Efficacy, safety, and patient preference of monoamine oxidase B inhibitors in the treatment of Parkinson's disease.Patient preference and adherence · 2011Article
- The role of rasagiline in the treatment of Parkinson's disease.Clinical interventions in aging · 2010Review
- Treatment of dysautonomia in extrapyramidal disorders.Therapeutic advances in neurological disorders · 2010Article
- Trends in the molecular pathogenesis and clinical therapeutics of common neurodegenerative disorders.International journal of molecular sciences · 2009Review
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe United Kingdom Parkinson's Disease Research Group (UKPDRG) trial found an increased mortality in patients with Parkinson's disease randomised to receive selegiline (10 mg/day) and levodopa compared with those taking levodopa alone. Unwanted effects of selegiline on cardiovascular regulation have been investigated as a potential cause for the unexpected mortality finding of the UKPDRG trial.
methodsThe cardiovascular responses to a range of physiological stimuli, including standing and head up tilt, were studied in patients with Parkinson's disease receiving levodopa alone and a matched group on levodopa and selegiline.
resultsHead up tilt caused selective and often severe orthostatic hypotension in nine of 16 patients taking selegiline and levodopa, but was without effect on nine patients receiving levodopa alone. Two patients taking selegiline lost consciousness with unrecordable blood pressures and a further four had severe symptomatic hypotension. The normal protective rises in heart rate and plasma noradrenaline were impaired. The abnormal response to head up tilt was reversed by discontinuation of selegiline. Drug withdrawal caused a pronounced deterioration in motor function in 13 of the 16 patients taking selegiline.
conclusionTherapy with selegiline and levodopa in combination may be associated with severe orthostatic hypotension not attributable to levodopa alone. Selegiline also has pronounced symptomatic motor effects in advanced Parkinson's disease. The possibilities that these cardiovascular and motor findings might be due either to non-selective inhibition of monoamine oxidase or to amphetamine and met-amphetamine are discussed.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.