Selegiline, also known as L-deprenyl and sold under the brand names Eldepryl and Emsam among others, is a medication which is used in the treatment of Parkinsons disease and major depressive disorder. It is provided in the form of a capsule or tablet taken by mouth for Parkinsons disease and as a patch applied to skin for depression. Selegiline acts as a monoamine oxidase inhibitor, and increases levels of monoamine neurotransmitters in the brain. At typical clinical doses used for Parkinsons disease, selegiline is a selective and irreversible inhibitor of monoamine oxidase B (MAO-B), increasing levels of dopamine in the brain. In larger doses (more than 20 mg/day), it loses its specificity for MAO-B and also inhibits MAO-A, which increases serotonin and norepinephrine levels in the brain. Medical uses
Parkinsons disease
In its pill form, selegiline is used to treat symptoms of Parkinsons disease. It is most often used as an adjunct to drugs such as levodopa (L-DOPA), although it has been used off-label as a monotherapy. The rationale for adding selegiline to levodopa is to decrease the required dose of levodopa and thus reduce the motor complications of levodopa therapy. Selegiline delays the point when levodopa treatment becomes necessary from about 11 months to about 18 months after diagnosis. There is some evidence that selegiline acts as a neuroprotectant and reduces the rate of disease progression, though this is disputed.Selegiline has also been used off-label as a palliative treatment for dementia in Alzheimers disease.
Moisturizers
Prevention of overheating
Eye drops (to prevent the eyes from becoming dried out)
Systemic Retinoids (isotretinoin and acitretin are very effective, but careful monitoring for toxicity is required. Only severe cases may require intermittent therapy. )Psychological therapy or support may be required as well. Ophthalmology Consult
ENT consult
Adequate nutrition
Monitor electrolytes < Collodion baby: An update with a focus on practical management. Renata Prado MD, Lixia Z Ellis MD, PhD, Ryan Gamble MD, Tracy Funk MD, Harvey Alan Arbuckle MD, Anna L Bruckner. Journal of the American Academy of Dermatology 2012;67:1362-1374>

See also
Ichthyosis
Congenital ichthyosiform erythrodema
Bullous congenital ichthyosiform erythroderma

References


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