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  1. Withdrawal severity scale

    from https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/019334s019s020lbl.pdf In theory, since MAO-A of the gut is not inhibited, patients treated with selegiline at a dose of 10 mg a day should be able to take medications containing pharmacologically active amines and consume tyramine-containing foods without risk of uncontrolled hypertension. Although rare, a few reports of hypertensive reactions have occurred in patients receiving Eldepryl at the recommended dose, with tyramine-containing foods.The pathophysiology of the ‘cheese reaction’ is complicated and, in addition to its ability to inhibit MAO-B selectively, selegiline’s relative freedom from this reaction has been attributed to an ability to prevent tyramine and other indirect acting sympathomimetics from displacing norepinephrine from adrenergic neurons. However, until the pathophysiology of the cheese reaction is more completely understood, it seems prudent to assume that selegiline can ordinarily only be used safely without dietary restrictions at doses where it presumably selectively inhibits MAO-B (e.g., 10 mg/day).
  2. Withdrawal severity scale

    And one more question regarding Selegiline. Are food restrictions required really for 5mg dosage? Is there real danger of cheese effect?
  3. Hello. Could you please share your experience. I was prescribed a dopaminergic drug as an adjunct. But there is an option. 1. Selegiline 2. Amantadine. 3. Cabergoline. As I understand all these drugs have different mechanism of action - dopamine receptor agonism (cabergoline), increasing dopamine release/dopamine reuptake inhibition(amantadine), MAO inhibition that causes dopamine level increase (selegiline). Could you evaluate frequency and severity of withdrawal syndrome? Which of the drugs has more likely and more severe withdrawal syndrome? And vice versa - less likely and less severe? I mean severe withdrawal syndrome like DAWS. My diagnosis is psychiatric, not Parkinson. Thank you.