Selegiline: Uses, Side Effects, Interactions, and More

The neurotransmitters, or chemical messengers, in your brain help control endless functions within the body. When these neurotransmitters are out of balance, medical conditions can develop like Parkinson’s disease and major depressive disorder. Certain medications can be used to help manage symptoms of these disorders by working with their brain chemistry. One of these medications is Selegiline.

Key takeaways:
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    Dopamine levels in the brain influence Parkinson’s disease and major depressive disorder.
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    The medication selegiline helps to make dopamine more readily available within the brain, making it useful for treating these conditions.
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    Selegiline does come with potentially dangerous side effects and contraindications, so it’s important to be informed when taking this medication.

What is selegiline?

Selegiline is an MAO-B inhibitor used for treating symptoms of Parkinson’s disease and depression. It is also sold under the name “deprenyl”. While selegiline can be incredibly helpful in treating these conditions, it does come with quite a few contraindications, precautions, and potential side effects.

Educating yourself gives you the tools to talk to your provider about the medication, and ask questions when necessary.

How does selegiline work?

MAO-B inhibitors mimic an enzyme in the body that breaks down neurochemicals, more specifically making dopamine more readily available in the brain.

Dopamine is a chemical messenger in the brain that also acts as a hormone. One of its main roles is regulating the brain’s reward system, but it is also essential for:

  • Learning and attention.
  • Mood and memory.
  • Movement.
  • Behavior.
  • Arousal and sleep.
  • Cognition.

Can selegiline treat depression?

Yes, selegiline is FDA-approved as a treatment for major depressive disorder (MDD). Because dopamine plays a huge role in cognition and brain health, it makes sense that selegiline could be used as a treatment for depression. People with depression also commonly experience anxiety as well. Selegiline can also help manage symptoms of anxiety.

When seeking treatment for depression, it’s understandable to want a medication that will work as fast as possible. Selegiline can take up to a few weeks to be effective, but you may notice differences within a few days of starting the medication.

Selegiline and Parkinson’s disease

While many associate dopamine with depression, it also plays a big role in Parkinson’s disease. Because selegiline increases dopamine levels, it is also used to help manage symptoms of Parkinson’s disease including tremors.

A common treatment for people with Parkinson’s disease is a combination of levodopa and carbidopa. Adding in selegiline can help optimize the use of those two medications to:

  • Control Parkinson’s symptoms longer.
  • Prolong the positive effects between doses.
  • Decrease the overall doses of medications.

While selegiline can help manage symptoms of Parkinson’s, it does not cure the disease.

Selegiline interactions with other drugs

Selegiline can potentially have interactions with other medications both over-the-counter (OTC) and prescription ones, including the following:

Generic nameBrand name
PropoxypheneDarvon
DextromethorphanRobitussin
MethadoneDolophine
MeperidineDemerol
Other medications that contain selegilineEmsam, Zelapar, Eldepryl

It may also have contraindications with other medications used for depression and anxiety including fluoxetine (Prozac) and selective serotonin reuptake inhibitors like citalopram (Celexa). Be sure to tell your provider about any other medications, supplements, or vitamins that you’re taking.

Selegiline contraindications

Certain underlying conditions can potentially increase your risk of experiencing side effects when taking selegiline. Talk to your doctor if you have any of the following:

  • Liver or kidney disease.
  • Phenylketonuria (PKU).
  • Pregnant or planning to become pregnant.
  • 65 years old or older.
  • High blood pressure.

Selegiline dietary instructions

People who are on a dose of 10 mg or less of selegiline have no restrictions on what they can or can’t eat. For doses higher than this, there is a possibility of dangerous interactions with certain foods.

Foods you should avoid when on selegiline

If you’re using selegiline, you should refrain from consuming the following:

  • Alcoholic drinks.
  • Alcohol-free or reduced alcohol wine, and beer.
  • Foods containing a high amount of tyramine including (fermented sausage, broad bean pods, cheeses, poultry, and fish).
  • High quantities of caffeine.

You can ask your healthcare provider for a full list of foods that may be contraindicated while taking selegiline. While it’s not a specific food to avoid if you take the dissolving tablet, you should not eat or drink for 5 minutes before and after taking your medicine.

Foods you can eat while using selegiline

Other foods may potentially increase your blood pressure to dangerous levels, a potential side effect of taking selegiline. You may be able to eat these foods, but with caution:

  • Soy products including yogurt and milk.
  • Any vegetables, except fava beans.
  • Certain meats.

Selegiline dose

There are two main ways to take selegiline – a dissolving tablet or capsule, both taken orally. The daily oral disintegrating tablet's initial dose is 1.25 mg, while the daily maximum dose is 10 mg.

The tablet is typically taken once daily without food or water, while the capsule is taken with breakfast and lunch, twice a day. For people taking the dissolving tablet, your provider may start you at a lower dose before increasing it at 6 weeks.

Selegiline can also be taken transdermally with a patch that’s applied to the skin. This method may be more effective for treating symptoms of depression than oral alternatives.

It’s important not to change your dose without the supervision of your doctor. Reach out to your provider if you experience any side effects. If you happen to miss a dose, take it as soon as you remember, unless it’s almost time for the next dose, then you can skip the missed one and move on to the next dose. Avoid making up for a missed dose by taking a double one.

Selegiline side effects

Some common side effects of taking selegiline include the following:

  • Stomach pain.
  • Dizziness, especially when you stand up too fast.
  • Lightheadedness.
  • Rash or purple blotches on the skin.
  • Difficulty swallowing.
  • Fainting.
  • Constipation or diarrhea.
  • Heartburn.
  • Unusual dreams.
  • Nausea.

These side effects tend to be more common when getting up after lying down. You can help avoid some of these side effects by getting up slowly and taking a few minutes to rest your feet on the floor before standing up.

Tell your doctor if any of these symptoms persist or if you experience any serious side effects including the following:

  • Difficult to control, unusual movements
  • Hallucinations
  • Severe and sudden nausea and vomiting
  • Sore or stiff neck
  • Severe headache
  • Unusual changes in behavior like sexual urges or unusual urges
  • Confusion
  • A sudden increase in high blood pressure
  • Chest pain

People taking selegiline for Parkinson’s may also experience side effects like sweating, stiff muscles, and fever when coming off the medication.

Starting a new medication or changing the one you’re currently on can bring up all sorts of questions and concerns. While there are certain potential side effects and contraindications to be aware of when taking selegiline, it can be life-changing for people with depression and Parkinson’s disease. You can help clear up any confusion by writing down a list of questions to bring to your healthcare provider.

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