What are the effects and side effects of selegiline/imidopir?

Selegiline/imidopyr(Selegiline), as a selective MAO-B inhibitor, was originally developed to delay the progression of Parkinson's disease symptoms. Its main mechanism of action is to inhibit the degradation of dopamine in the brain, allowing dopamine to stay in the synaptic cleft longer, thereby improving motor dysfunction. Because of this, Selegiline has certain application value in the fields of neurology and psychiatry.

In the treatment of Parkinson's disease, the efficacy of selegiline is mainly reflected in delaying early patients' dependence on levodopa and reducing symptoms of bradykinesia and rigidity. Clinical practice shows that it can moderately improve the condition when treated as a single drug, and when combined with levodopa, it can extend the duration of the effect and reduce the occurrence of "switching phenomenon".

In some countries, it has also been tried to treat depression, especially for patients with refractory depression. The transdermal formulation of selegiline has shown certain efficacy because it avoids the first-pass effect. However, along with its efficacy is the risk of side effects that cannot be ignored. Common adverse reactions include insomnia, headache, dry mouth, blood pressure fluctuations, and indigestion. Some patients experience hyperactivity or sleep disorders after taking medication at night, which is related to the metabolism of selegiline into amphetamine. Some people may also experience orthostatic hypotension or tachycardia, which increases the risk of falls for older patients.

More importantly, selegiline has hidden dangers in drug interactions. Because it inhibits monoamine oxidase, if patients consume too much tyramine-containing foods in their diet (such as aged cheese, pickled foods), it may induce hypertensive crisis. At the same time, if combined with SSRIs, SNRIs or certain analgesics, it can easily lead to serotonin syndrome, a potentially fatal drug reaction. Because of this, clinicians often need to conduct a detailed assessment of the patient's medication history and dietary habits when prescribing this drug.

Reference: https://www.drugs.com/mtm/selegiline.html