Selegiline: what it does and how to use it
Selegiline can boost dopamine by blocking MAO-B, which helps people with Parkinson’s disease and in some forms of depression. This medicine comes as tablets, orally disintegrating tablets, and a skin patch. You’ll see it used alone in early Parkinson’s or added to levodopa to reduce motor fluctuations. The transdermal patch (brand Emsam) is approved for major depressive disorder and delivers steady drug levels over 24 hours.
How selegiline works is straightforward: it selectively inhibits monoamine oxidase B (MAO-B) at typical doses. That slows breakdown of dopamine in the brain and raises dopamine levels. At higher doses the drug loses selectivity and inhibits MAO-A too, which changes safety rules and increases dietary risks.
Forms and dosing matter. Oral selegiline often comes in low milligram doses taken once or twice daily; orally disintegrating tablets let the drug absorb under the tongue. The patch is measured in mg per 24 hours — common options are 6, 9, and 12 mg. The 6 mg patch usually does not require a tyramine-restricted diet, but 9 mg and 12 mg do. Never mix formulations without checking with your prescriber.
Watch for interactions. Combining selegiline with SSRIs, SNRIs, TCAs, meperidine, tramadol, or certain decongestants can trigger serotonin syndrome or severe reactions. At higher doses or with MAO-A inhibition, eating high-tyramine foods—aged cheeses, cured meats, some fermented products—may raise blood pressure. Always tell your doctor or pharmacist every medication and supplement you take before starting selegiline.
Common side effects include insomnia, nausea, dizziness, dry mouth, and mild anxiety. In Parkinson’s patients it can also cause vivid dreams or increase dyskinesia when used with levodopa. Older adults may be more prone to low blood pressure and confusion. If you develop severe headache, chest pain, high fever, or muscle stiffness, seek emergency help — those can be signs of dangerous interactions.
Practical tips for daily use: take oral doses early in the day to reduce insomnia, avoid alcohol and illicit stimulants, and keep a current medication list in your wallet. If you use the patch, apply it to clean, dry skin and rotate sites; remove before MRI and follow disposal instructions. When changing doses or stopping selegiline, follow your prescriber's plan to avoid withdrawal or interaction risks.
Follow-up and monitoring are simple: your clinician will check blood pressure, ask about sleep and mood, and monitor movement symptoms if you have Parkinson’s. If treatment isn’t helping or causes troubling effects, there are alternatives and dose strategies to discuss. Talk openly with your care team — that’s the fastest way to make selegiline work safely for you.
Questions to ask your doctor
Ask whether selegiline is the best choice for your symptoms, which formulation fits your lifestyle, and whether any current medicines must stop. Clarify sleep effects, blood pressure checks, and how long before you expect benefits. If you plan pregnancy or breastfeeding, get a clear plan. Also ask about what to do in case of missed doses and when to seek emergency care for severe reactions. Keep this info handy and discuss openly soon.
Selegiline and its potential role in treating schizophrenia
In my latest blog post, I explored the potential role of Selegiline in treating schizophrenia. This drug, typically used for Parkinson's disease, has been showing promising results in recent studies for alleviating symptoms of schizophrenia. Selegiline works by inhibiting the breakdown of dopamine, which is believed to have an impact on the positive and negative symptoms experienced by patients with schizophrenia. While more research is needed, Selegiline could potentially become a new treatment option for those suffering from this complex mental illness. Keep an eye out for updates on this fascinating development in the world of mental health!
