A MAO-B inhibitor for Parkinson's
Selegiline
An oral MAO-B inhibitor used in Parkinson's disease, on its own in early disease or alongside levodopa to smooth out symptom control.
What is Selegiline?
Selegiline is a MAO-B inhibitor used to treat Parkinson's disease. It can be used early on its own to ease symptoms, or added to levodopa to make each dose last longer and reduce 'wearing off'. It works by slowing the breakdown of dopamine in the brain.
Education and reference only. This is a plain-language guide to Selegiline — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Selegiline is one of the older MAO-B inhibitors used in Parkinson's disease. It can be prescribed on its own in early Parkinson's to give modest symptom relief and delay the need for levodopa, or added to levodopa later to help each dose work for longer. It is taken by mouth and is generally used long-term as part of a combination of Parkinson's medicines tailored to the person.
How it works
Selegiline blocks an enzyme called monoamine oxidase type B (MAO-B), which normally breaks down dopamine in the brain. Because dopamine is the chemical messenger that is in short supply in Parkinson's disease, slowing its breakdown leaves more available to support movement. When used with levodopa, this helps each levodopa dose last longer and steadies symptom control between doses.
Company & origin
Originated / developed by: Originally developed in Hungary by Chinoin (now part of Sanofi)..
Synthesised in Hungary in the 1960s by Jozsef Knoll and colleagues at Chinoin, and later established as an early MAO-B inhibitor for Parkinson's disease.
What it treats
Conditions Selegiline is used for
Practical use
How to take Selegiline
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it at the times your prescriber recommends, usually earlier in the day to reduce the chance of sleep disturbance.
- It can be taken with or without levodopa depending on your treatment plan.
- If your doctor adds it to levodopa, your levodopa dose may be reduced to limit involuntary movements.
- Take it consistently each day; do not stop suddenly, as this can worsen Parkinson's symptoms.
- Tell your prescriber and pharmacist about all other medicines, especially antidepressants and strong painkillers.
Weighing it up
Advantages & disadvantages of Selegiline
Advantages
- Can be used early on its own to ease symptoms and may delay the need for levodopa.
- When added to levodopa, helps each dose last longer and reduces 'wearing off'.
- Taken by mouth as a simple once-daily or twice-daily routine for most people.
Disadvantages
- Can be mildly stimulating and disturb sleep, so timing matters.
- May worsen levodopa-related involuntary movements (dyskinesia).
- Carries a risk of serious interactions with certain antidepressants and opioids.
Practical use
Good to know
Selegiline can be mildly stimulating and may disturb sleep, so it is usually taken earlier in the day rather than at night. It can be used with or without levodopa, but when added to levodopa it may unmask or worsen involuntary movements (dyskinesia), which the levodopa dose can be adjusted to manage. Parkinson's medicines should not be stopped abruptly.
Who should not take it / use with caution
- People taking certain antidepressants (such as SSRIs, SNRIs and other MAOIs) or the painkiller pethidine, because of the risk of a serious reaction.
- People with active stomach or duodenal ulcers, or uncontrolled high blood pressure, need caution and specialist advice.
- Anyone whose Parkinson's specialist advises against it based on their full medicine list.
Monitoring
- Review of Parkinson's symptoms and how long each levodopa dose lasts.
- Blood pressure, including checks for dizziness on standing.
- Watch for new confusion, hallucinations or excessive daytime sleepiness.
Side effects
- Sleep disturbance or vivid dreams, especially if taken late in the day.
- Nausea, dizziness or light-headedness on standing.
- Worsening of involuntary movements when used with levodopa.
- Confusion or hallucinations, more likely in older or frail people.
Key interactions
- Pethidine (and some other opioids such as tramadol) — risk of a serious reaction (serotonin syndrome); avoid.
- SSRI, SNRI and other antidepressants — risk of serotonin syndrome; combinations need specialist caution or avoidance.
- Other MAO inhibitors — should not be combined.
- Sympathomimetic decongestants — can raise blood pressure.
Available as: Tablets and oral lyophilisates that dissolve in the mouth.
Answers
Selegiline: frequently asked questions
Can selegiline be used on its own?
Yes. In early Parkinson's it can be used alone to give modest symptom relief and may delay the need for levodopa. Later it is often added to levodopa to make each dose last longer.
Why should I take it earlier in the day?
Selegiline can be mildly stimulating and may disturb sleep. Taking it earlier rather than at night reduces the chance of insomnia or vivid dreams.
Can I take selegiline with antidepressants?
Not freely. Combining it with certain antidepressants such as SSRIs and SNRIs can cause a serious reaction called serotonin syndrome. Always tell your specialist about every antidepressant you take.
Will it cause the involuntary movements I get with levodopa?
It can unmask or worsen levodopa-related involuntary movements (dyskinesia). If this happens, your specialist can adjust your levodopa dose to help.
Can I stop selegiline suddenly?
No. Parkinson's medicines should not be stopped abruptly, as this can lead to a sharp worsening of symptoms. Any changes should be guided by your specialist.
The wider class
About MAO-B inhibitors
Selegiline belongs to the mao-b inhibitors class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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