Selegiline side effects

    
      Re: Selegiline side effects
    


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Posted by CCF Neuro MD on July 02, 1997 at 19:50:44:

In Reply to: Selegiline side effects posted by Carole Manning on June 21, 1997 at 15:33:49:

: My doctor prescribed selegiline 5 mg BID for depression,and worsening short term memory loss. It was the most effective of any antidepressent I have taken, and my memory improved markedly. However, even on 1/4 of the normal dose, I had nausea and vomiting, only partially controlled by Tigan, so I had to discontinue the med. Since selegiline is primarily used for Parkinson's disease, I thought you might know how to control the side effects, or what drugs would have similar mechanisms of action. The memory loss is worsening, and is interferring with my job performance.  (I am 49 and my mother and grandmother both experienced progressive short term memory loss, not accompaniend by dementia, as they aged.)
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Dear Carole:
Selegiline belongs to a class of drugs called MAOI inhibitors that were initially developed for the treatment of depression. The major indication for the use of selegiline is to partially retard the rate of progression of Parkinson's disease. A more recent study in the N Eng J Med indicates that it may also be effective in retarding the progression of Alzheimer's disease. In less conclusive studies, it has been shown to improve subjective and objective measures of memory, and has also been found to be an effective antidepressant. I am not surprised that you feel better emotionally and cognitively on selegiline. Vomiting occurs in about 10% of cases on the medication and may respond to conventional antiemetics such as tigan. Other antiemetics that may be tried include domperidone (not available in the US), and ondansetron. Antiemetics, however, have significant long-term side effects, and I rather would favor conservative measures such as manipulating the timing of medication, taking it with food, etc. Also, there might be efficacious alternatives to selegiline. I guess that you are aware that it might be dangerous to combine selegiline with SSRI antidepressants such as Prozac, Zoloft and Paxil.
I am concerned about your family history of memory deficits, and your very significant worries about your own memory. Although it seems unlikely, I cannot exclude the possibility of a heredofamilial neurodegenerative disorder to account for your symptoms. I suggest that you see a neurologist interested in neurodegenerative/cognitive disorders in an academic department, and also possibly undergo formal neuropsychological testing. I you live in the Cleveland area, you might want to see Dr. R. S. Burns, Dr. Richard Lederman, or Dr. Patrick Sweeney at the Cleveland Clinic. You could call up [phone] or [phone] for an appointment.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options of your specific medical condition.