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Moclobemide and selegeline in the treatment of depression in Parkinson’s disease
  1. ERNST N H JANSEN STEUR
  1. Department of Neurology
  2. Department of Clinical Chemistry, MST Hospital, Enschede, The Netherlands
  1. Dr E N H Jansen Steur, Department of Neurology, Hospital Medisch Spectrum Twente, PO Box 50.000, 7500 KA, Enschede, The Netherlands. Telephone +31 53 4872000; fax +31 53 4873100.
  1. LEO A P BALLERING
  1. Department of Neurology
  2. Department of Clinical Chemistry, MST Hospital, Enschede, The Netherlands
  1. Dr E N H Jansen Steur, Department of Neurology, Hospital Medisch Spectrum Twente, PO Box 50.000, 7500 KA, Enschede, The Netherlands. Telephone +31 53 4872000; fax +31 53 4873100.

https://doi.org/10.1136/jnnp.63.4.547

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    Monoamine oxidase (MAO) is the predominant enzyme implied in the catabolism of the monoamines dopamine, noradrenaline, and serotonin.1 Dopamine is a substrate for both isoforms of MAO: the extraneuronal MAO-B; and MAO-A which is found both extraneuronally and intraneuronally.2 Intraneuronal MAO-A is active for dopamine, noradrenaline, and serotonin, which have a paramount influence in the pathogenesis of depression. The combination of MAO-A and MAO-B inhibition results in a strong increase of both dopamine, noradrenaline, and serotonin. Depression is the most frequent psychopathological finding in Parkinson’s disease.

    In this study we compared moclobemide monotherapy with combined therapy with moclobemide and selegeline, under tyramine restriction.

    Ten patients with idiopathic Parkinson’s disease of two to 15 years in duration contributed to the study. The actions of moclobemide and selegeline were described in the informed consent. Inclusion criteria were Parkinson’s disease disability Hoehn and Yahr stages II-IV, major depression using DSM III.R criteria, mini mental state examination (MMSE) score of 21 or above, and self recorded “on-off” patient …

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