Patients who are experiencing ‘wearing-off’ may benefit from taking a monoamine oxidase type B inhibitor (MAO-B inhibitor).5,6 MAO-B inhibitors inhibit the breakdown of either dopamine or levodopa in the body, thus prolonging their therapeutic effect and time spent in ‘ON’ states.7 MAO-B inhibitors may be used during early PD, before the patient moves on to more potent treatments, such as dopamine agonists or levodopa.7
References:
1. Stocchi F. Conventional treatment-related motor complications: their prevention and treatment. In: Wolters & Baumann (eds). Parkinson Disease and Other Movement Disorders. VU University Press, 2014.
2. Fox SH, Katzenschlager R, Lim S-Y, et al. International Parkinson and Movement Disorder Society evidence-based medicine review: update on treatments for the motor symptoms of Parkinson’s disease. Mov Disord 2018; 33 (8): 1248–1266.
3. Tan Y-Y, Jenner P, Chen S-D. Monoamine oxidase-B inhibitors for the treatment of Parkinson’s disease: past, present, and future. J Parkinsons Dis 2022; 12 (2): 477–493.
4. Schapira AH, Fox SH, Hauser RA, et al. Assessment of safety and efficacy of safinamide as a levodopa adjunct in patients with Parkinson disease and motor fluctuations: a randomized clinical trial. JAMA Neurol 2017; 74 (2): 216–224.
5. de Bie RMA, Katzenschlager R, Swinnen BEKS, et al. Update on treatments for Parkinson’s disease motor fluctuations – An International Parkinson and Movement Disorder society evidence-based medicine review. Mov Disord 2025; doi: 10.1002/mds.30162.
6. Factor SA. Current status of symptomatic medical therapy in Parkinson’s disease. Neurotherapeutics 2008; 5 (2): 164–180.
7. Connolly BS, Lang AE. Pharmacological treatment of Parkinson disease: a review. JAMA 2014; 311 (16): 1670–1683.
