Monoamine Oxidase Type B Inhibitors in the Treatment of Early Parkinson’s Disease

Abstract

Therapy in Parkinson’s disease (PD) needs to be individualized since patients differ in symptom expression and responsiveness to pharmacotherapy. Disease-modifying drugs should be considered early in the course of the disease, but none is currently US Food and Drug Administration (FDA)-approved for this indication. Symptomatic therapies should be optimized to keep the patient independent and functioning for as long as possible. Early therapies in PD consist of dopamine agonists, monoamine oxidase type B (MAO-B) inhibitors, and, in some patients, carbidopa–levodopa (depending on age and symptom severity). MAO-B inhibitors are approved by the FDA for monotherapy in treatment of early PD and as an adjunct to levodopa in advanced disease. This article focuses on the role of MAO-B enzymes in PD pathogenesis and reviews clinical evidence for the use of MAO-B inhibitors in the treatment of early PD.