Mechanism of effect
Monoamine Oxidase Type B (MAO-B) is an enzyme in our body that breaks down several chemicals in the brain, including dopamine. By giving a medication that blocks the effect of MAO-B, an MAO-B inhibitor), more dopamine is available to be used by the brain. This can modestly improve many motor symptoms of PD.
MAO-B inhibitors also provide some benefit for the motor symptoms of PD and are useful as early monotherapy or as an add-on to other medications, including levodopa. When used with other medications, MAO-B inhibitors may reduce “off” time and extend “on” time.
Drug indications
Lazabemide is effective in treatment of Alzheimer′s disease and in combination with nicotine replacement therapy aids in smoking cessation.
Dosage
In clinical trial against Parkinson's disease, lazabemide was administered orally at doses 25-200 mg/day
Side effects
Common Side Effects of MAO-B Inhibitors:
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Mild nausea
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Dry mouth
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Lightheadedness
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Constipation
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Confusion (can occur in elderly people with PD)
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Hallucinations (can occur in elderly people with PD)
Interactions
- Substances that are metabolized by monoamine oxidase, as they can be boosted by up to several-fold.
- Substances that increase serotonin, norepinephrine, or dopamine activity, as too much of any of these neurochemicals can result in severe acute consequences, including serotonin syndrome, hypertensive crisis, and psychosis, respectively.
Points of recommendation
- Taking some MAO-B inhibitors with the heavy consumption (greater than 150 mg/day) of foods high in tyramine carries a risk of raising blood pressure to dangerous levels. These foods are typically aged or fermented, and can include things like cheeses, dried or cured meats, fava beans, beer, sauerkraut, and soybeans. This is more of a risk with non-selective MAO-B inhibitors not used to treat Parkinson’s disease.
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