HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Correspondence: View responses Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Donnan, P.T. Articles by MacDonald, T.M. Search for Related Content PubMed PubMed Citation Articles by Donnan, P.T. Articles by MacDonald, T.M.

Selegiline and mortality in subjects with Parkinson’s disease

A longitudinal community study

From the Medicines Monitoring Unit (MEMO), Department of Clinical Pharmacology, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland, UK.

Address correspondence and reprint requests to Dr. Peter T. Donnan, Medicines Monitoring Unit (MEMO), Department of Clinical Pharmacology, University of Dundee, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK; e-mail: peterd{at}memo.dundee.ac.uk

OBJECTIVE: To estimate mortality by drug use in a cohort of patients with PD relative to age- and sex-matched comparators.

METHODS: two longitudinal cohorts of patients with 7 and 11 years’ duration of PD were constructed with matched comparators in Tayside, Scotland. Subjects were eligible for inclusion if they received a first prescription for an anti-Parkinson’s drug from July 1989 to December 1995, with no PD drug prescription in the previous 6 months. Those who had previously taken a neuroleptic drug or were younger than 40 years of age were excluded.

RESULTS: Overall, subjects with PD in relation to comparators had higher mortality with a rate ratio (RR) of 1.76 (95% CI 1.11, 2.81) in the 7-year cohort. There was significantly greater mortality in patients with PD who received levodopa monotherapy (RR = 2.45, 95% CI 1.42, 4.23) relative to the comparators, adjusting for previous cardiovascular drug use and diabetes. However, there was no significant difference in mortality in those with PD receiving combination therapy of selegiline with levodopa and other drugs in relation to the comparators (RR = 0.92, 95% CI 0.37, 2.31).

CONCLUSIONS: Subjects with PD had twice the rate of mortality relative to age- and sex-matched comparators. However, those subjects who received selegiline at any time in combination with co-careldopa or co-beneldopa showed no significant difference in mortality compared with the comparators. Monotherapy with levodopa was associated with the highest mortality.

This article has been cited by other articles:

				J. A. Driver, T. Kurth, J. E. Buring, J. M. Gaziano, and G. Logroscino Parkinson disease and risk of mortality: A prospective comorbidity-matched cohort study Neurology, April 15, 2008; 70(16_Part_2): 1423 - 1430. [Abstract] [Full Text] [PDF]

				L. S Ishihara, A. Cheesbrough, C. Brayne, and A. Schrag Estimated life expectancy of Parkinson's patients compared with the UK population J. Neurol. Neurosurg. Psychiatry, December 1, 2007; 78(12): 1304 - 1309. [Abstract] [Full Text] [PDF]

				E. J. Metter, M. Schrager, L. Ferrucci, and L. A. Talbot Evaluation of Movement Speed and Reaction Time as Predictors of All-Cause Mortality in Men J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2005; 60(7): 840 - 846. [Abstract] [Full Text] [PDF]

				G. Levy, M.-X. Tang, E.D. Louis, L.J. Cote, B. Alfaro, H. Mejia, Y. Stern, and K. Marder The association of incident dementia with mortality in PD Neurology, December 10, 2002; 59(11): 1708 - 1713. [Abstract] [Full Text] [PDF]

				G. Nicholson, A. C. Pereira, and G. M. Hall Parkinson's disease and anaesthesia Br. J. Anaesth., December 1, 2002; 89(6): 904 - 916. [Abstract] [Full Text] [PDF]

				J. A. Van Gerpen, J. E. Ahlskog, Y. Ben-Shlomo, J. Head, A. Lees, P. T. Donnan, D. T. Steinke, P. G. Davey, and T. M. MacDonald Selegiline and mortality in subjects with Parkinson's disease: A longitudinal community study Neurology, July 24, 2002; 57(2): 368 - 370. [Full Text] [PDF]

				M. Guttman, P. M. Slaughter, M.-E. Theriault, D. P. DeBoer, and C. D. Naylor Parkinsonism in Ontario: Increased mortality compared with controls in a large cohort study Neurology, December 26, 2001; 57(12): 2278 - 2282. [Abstract] [Full Text] [PDF]

				J. W. Langston and C. M. Tanner Selegiline and Parkinson's disease: It's deja vu--again Neurology, December 26, 2000; 55(12): 1770 - 1771. [Full Text] [PDF]

Correspondence: