[Selegiline in the treatment of Alzheimer's disease]

Alzheimer's disease accounts for 60-70% of all dementias. Although its etiology has not been elucidated so far, its multiple transmitter effect has been proved reliably. Treatment with selegiline, 10 mg per day, which blocks irreversibly monoaminooxidase type B, when administered on a long-term basis, revealed improvement of cognitive functions and of general functional fitness during objective examinations by means of a battery of psychometric tests. The danger of a hypertensive crisis due to excessive supplies of exogenous monoamines ("cheese effect") can be ruled out when this dose is used. Selegiline has moreover a detoxicating potential and the ability to block the transformation of some protoxins into an effective toxin. The reduced formation of free radicals is of particular importance. The latter participate in a significant way in the destruction of cellular membranes, proteins and nucleic acids. In experiments on rats selegiline improves sexual functions, learning and its use significantly prolongs survival. As a symptomatic drug selegiline is the drug of choice in AD. Only future studies will show the justification of extensive preventive medication in advanced age groups.