MAOB enzyme inhibitor family

Generic name: Selegiline

Commercial name: Jumex

  • Selegiline is mainly effective at the beginning of the disease, when the symptoms of the disease are mild, but it can also be used in advanced stages of the disease in combination with other Parkinson's drugs.
  • Selegiline acts on an enzyme called MAOB, prevents the breakdown of dopamine and thus increases dopamine levels in the brain.
  • As of today, there is no evidence that selegiline significantly changes the course of the disease.
  • Used to prolong the effect time of the dose of levodopa (Dupicare, Levopress), or to reduce the necessary amount of Dupicer or Levopress.
 

Advantages

Selegiline may slightly improve symptoms and delay the need for levodopa.

May reduce the fluctuations in the degree of effectiveness of drugs, which some patients with Parkinson's disease feel, after the first years.

Disadvantages

The effect of the treatment on the symptoms is relatively weak.

One of the side effects to be aware of is called orthostatic hypotension.

Side Effects

A drop in blood pressure when standing up from sitting or lying down.

Click here to review the Ministry of Health's circular from the "All Health" Selegiline website

Click here to review the circular of the Ministry of Health "All Health" jumax

Generic name: Rasagaline  

Trade name: Azilect            

  • A drug that can be used as a single drug treatment in the early stages of Parkinson's disease.
  • Inhibits the breakdown of dopamine and thus increases the availability of dopamine.
  • Similar to selegiline, rasagiline is also a unique and irreversible inhibitor of the MAO-B enzyme that breaks down dopamine in the basal ganglia.
 

Advantages

The method of treatment with the preparation is convenient, giving the medicine once a day, without the need to monitor the doses.

According to the clinical trial, there was evidence that this drug can slow down the progression of the disease by a small amount.

Disadvantages

Side Effects

Relatively rare.
May cause orthostatism (drops in blood pressure).

Click here to review the Ministry of Health's circular from the "All Health" website

Generic name: Xadago             

Trade name: Safinamide  

  • Spinamide is given to Parkinson's patients with motor fluctuations in an intermediate to advanced stage as an addition to stable treatment only
  • like the previous drugs (Selegiline וRasagiline) Spinamide is a selective inhibitor of MAO-B but its activity is reversible and very specific.
  • Laspinamide has another mechanism of action that regulates levels of glutamate. Glutamate plays a role in both motor and non-motor symptoms in Parkinson's.
  • The drug is not registered in Israel, but is imported into Israel, as needed, under special permission of משרד הבריאות.

 

Advantages

Can improve motor symptoms when given together with levodopa.

It does not cause a drop in blood pressure and therefore can be an alternative for people who have developed a drop in blood pressure due to treatment with Azilact/Jumax.

Disadvantages

Side Effects

Distorted or uncontrolled muscle movements

Confusion, unusual thoughts or behavior.

Hallucinations, fever, sweating, rapid pulse, nausea, vomiting, diarrhea.

Increased blood pressure - greater headache, blurred vision, pounding neck or ears, anxiety, nosebleeds.

Click here toExpansion on the association's website

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