O

6.08.3.5.3.1 Monoamine oxidase-B inhibitors

Selegiline 64 is an irreversible MAO-B inhibitor approved as adjunct therapy in PD patients being treated with L-dopa. Rasagaline (67) is a newer irreversible MAO inhibitor highly selective for MAO-B: it is 5-10 times more active than selegeline.72 It cannot be metabolized to amphetamine and thus does not produce amphetamine-like behavioral effects.

6.08.3.5.3.2 Catechol O-methyltransferase inhibitors

Inhibition of COMT prevents metabolism of L-dopa. Entacopone 65 and tolcapone 66 are COMT inhibitors approved for adjunct treatment to L-dopa in PD. Entacopone is an improvement over tolcapone in terms of liver toxicity issues.

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