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

Selegiline/imidopyr(Selegiline) is a selective monoamine oxidaseB (MAO-B) inhibitor. It is mainly used for the treatment of Parkinson's disease and has also been studied in the fields of depression, cognitive impairment and other fields. Although this class of drugs has important clinical value, its side effects and contraindications also deserve attention. According to overseas data, the side effects of selegiline are related to its inhibition of MAO-B. This effect can prolong the action time of dopamine in the synaptic cleft. Therefore, common adverse reactions are closely related to increased dopamine levels. For example, some patients may experience insomnia, headache, dizziness, anxiety or indigestion, which is related to the drug stimulating the central nervous system or affecting gastrointestinal motility. A small number of people may also experience palpitations, blood pressure fluctuations, or dry mouth, which are more likely to occur at higher doses or when combined with other medications.

Selegiline may also cause drug-drug interactions, especially when used in combination with certain antidepressants such asSSRIs, SNRIs, or tricyclic drugs. There is a risk of serotonin syndrome, a potentially dangerous drug reaction that can lead to serious consequences such as high fever, muscle stiffness, and disturbance of consciousness. Clinical guidelines therefore clearly emphasize avoiding concomitant use with these drugs. In addition, foods high in tyramine (such as certain cheeses, red wine, pickled products) may interact with MAO inhibition at high doses, causing a significant increase in blood pressure, although the risk is low at regular doses.

In terms of contraindications, one of the most important contraindications of selegiline is that it cannot be used by those who are allergic to the drug ingredients; secondly, patients with active peptic ulcers or severe liver and kidney dysfunction need to be particularly cautious when using it, as their metabolism and clearance may be affected; in addition, patients who are receiving noradrenergic or serotonergic drugs should not use it at the same time to avoid increasing the risk of serious adverse reactions. For pregnant and lactating women, use is generally not recommended due to lack of adequate safety data.

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