Time course of physical and psychological responses to selegiline monotherapy in newly diagnosed, idiopathic parkinsonism

Poor specificity of face-value endpoints and the poor sensitivity of gross clinical examination may have militated against demonstrating prophylaxis by selegiline. Objective measures of the four cardinal signs were used as primary outcome criteria in a randomised, double-blind, placebo-controlled, p...

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Bibliographic Details
Published in:European journal of clinical pharmacology 1996, Vol.50 (1-2), p.7-18
Main Authors: Kirollos, C, Charlett, A, Bowes, S G, Purkiss, A G, O'Neill, C J, Weller, C, Dickins, J, Faulkner, G, Nicholson, P W, Hunt, W B, Dobbs, R J, Dobbs, S M
Format: Article
Language:English
Subjects:
Aged
Antiparkinson Agents - pharmacokinetics
Antiparkinson Agents - therapeutic use
Arousal - physiology
Double-Blind Method
Female
Gait - drug effects
Gait - physiology
Humans
Hypokinesia - drug therapy
Hypokinesia - physiopathology
Male
Muscle Rigidity - drug therapy
Muscle Rigidity - physiopathology
Parkinson Disease - drug therapy
Parkinson Disease - physiopathology
Parkinson Disease - psychology
Posture - physiology
Psychomotor Performance - drug effects
Research Design
Selegiline - pharmacokinetics
Selegiline - therapeutic use
Treatment Outcome
Tremor - drug therapy
Tremor - physiopathology
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Summary:Poor specificity of face-value endpoints and the poor sensitivity of gross clinical examination may have militated against demonstrating prophylaxis by selegiline. Objective measures of the four cardinal signs were used as primary outcome criteria in a randomised, double-blind, placebo-controlled, parallel group study of selegiline monotherapy in 25 newly diagnosed elderly sufferers from idiopathic parkinsonism, stratified for sex and Hoehn and Yahr functional staging. There was a significant interaction between time and nature of treatment with respect to rigidity. The effect of time during active treatment was highly significant: rigidity decreased by 1.3% per week. The worsening of rigidity on placebo was not statistically significant. Neuronal rescue is a possible explanation for the long term, progressive improvement produced by selegiline. No significant treatment effect was seen on the other cardinal signs. However, there was a significant quadratic time trend for arousal on active treatment suggesting tolerance to this effect. The difference in time course between the psychostimulant and physical effects suggests more than one mode of action.
ISSN:0031-6970