Monoamine oxidase-B inhibitors in the treatment of Parkinson’s disease: clinical–pharmacological aspects

  • Peter Riederer
  • Thomas Müller
Neurology and Preclinical Neurological Studies - Review Article


This invited narrative review emphasizes the role of MAO-B inhibition in the drug portfolio for dopamine substitution in patients with Parkinson’s disease. Neuronal and glial MAO-B inhibition contributes to more stable levels of dopamine and other biogenic amines in the synaptic cleft. Accordingly, symptomatic effects of MAO-B inhibition for a limited amelioration of impaired motor behaviour and wearing-off phenomena in patients with Parkinson’s disease are well proven, even when MAO-B inhibitors are only applied together with dopamine agonists. Delay of disease progression by MAO-B inhibition is under debate despite positive experimental findings. This discussion does not consider, that levodopa, respectively, dopamine agonists, are substrates, respectively, inhibitors of the ABCB1 (P-gp, MDR1, and CD243) transporter system. It supports toxin efflux over the blood–brain barrier. ABCB1 transporters have a limited capacity. MAO-B inhibitors do not weaken it. Treatment with MAO-B inhibitors is advantageous as it enables sparing of dopamine agonist and levodopa dosing.


Monoamine oxidase Selegiline Rasagiline Safinamide ABCB1 transporter 


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Center of Mental Health, Department of Psychiatry, Psychosomatics and PsychotherapyUniversity Hospital WürzburgWürzburgGermany
  2. 2.Department of NeurologySt. Joseph Hospital Berlin-WeißenseeBerlinGermany

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