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Monoamine oxidase-B inhibitors in the treatment of Parkinson’s disease: clinical–pharmacological aspects

  • Neurology and Preclinical Neurological Studies - Review Article
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Abstract

This invited narrative review emphasizes the role of MAO-B inhibition in the drug portfolio for dopamine substitution in patients with Parkinson’s disease. Neuronal and glial MAO-B inhibition contributes to more stable levels of dopamine and other biogenic amines in the synaptic cleft. Accordingly, symptomatic effects of MAO-B inhibition for a limited amelioration of impaired motor behaviour and wearing-off phenomena in patients with Parkinson’s disease are well proven, even when MAO-B inhibitors are only applied together with dopamine agonists. Delay of disease progression by MAO-B inhibition is under debate despite positive experimental findings. This discussion does not consider, that levodopa, respectively, dopamine agonists, are substrates, respectively, inhibitors of the ABCB1 (P-gp, MDR1, and CD243) transporter system. It supports toxin efflux over the blood–brain barrier. ABCB1 transporters have a limited capacity. MAO-B inhibitors do not weaken it. Treatment with MAO-B inhibitors is advantageous as it enables sparing of dopamine agonist and levodopa dosing.

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  1. Center of Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel Platz 1, 97080, Würzburg, Germany

    Peter Riederer

  2. Department of Neurology, St. Joseph Hospital Berlin-Weißensee, Berlin, Germany

    Thomas Müller

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  1. Peter Riederer
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  2. Thomas Müller
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Correspondence to Peter Riederer.

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Riederer, P., Müller, T. Monoamine oxidase-B inhibitors in the treatment of Parkinson’s disease: clinical–pharmacological aspects. J Neural Transm 125, 1751–1757 (2018). https://doi.org/10.1007/s00702-018-1876-2

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