DOI: https://doi.org/10.22141/2224-0713.5.107.2019.176705

The role of monoamine oxidase B inhibitor rasagiline in the treatment of Parkinson’s disease

A.V. Demchenko

Abstract


The article discusses the problem of Parkinson’s disease (PD), which is the second most important neurodegenerative disease in developed society after Alzheimer’s disease. In Ukraine, the prevalence of PD is 140 cases per 100,000 population. The main factors that increase the mortality rate in PD are dementia, the presence of hallucinations, dysphagia, the predominance of akinetic and rigid form with early impaired balance and gait. Absence of classical resting tremor, symmetry of symptoms are associated with decreased survival, while the presence of resting tremor — with its increase. The main problem in the treatment of PD is that, despite significant improvement in the quality of life of patients and pronounced symptomatic effect, in general, modern therapeutic options do not yet allow preventing further degeneration of dopaminergic neurons and disease progression. Therefore, clinical practice requires therapy influencing the pathogenetic basis of the disease. This is especially important when patients in the early stages of PD have the highest neuroplastic reserve, and the strategy for their continuous treatment should be oriented for decades to come. The development of new therapeutics, including selective monoamine oxidase (MAO) inhibitors, has changed the “face” of PD treatment. Patients aged 50–70 years with low and moderate motor deficits and without significant cognitive impairment receive treatment with MAO-B inhibitor or dopamine receptor agonists, in severe motor disorders — with levodopa preparations, and when its small doses (300–400 mg/day) do not provide sufficient clinical effect, MAO-B inhibitor, dopamine receptor agonists or amantadine are prescribed additionally to avoid further increase in levodopa dose. Adding MAO-B inhibitor and/or dopamine receptor agonists to levodopa makes it possible to reduce its dose by 15–30 % without loss of effectiveness and helps delay the development of motor fluctuations.

Keywords


Parkinson’s disease; treatment; selective monoamine oxidase inhibitors

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