Eldepryl is a brand name for selegiline, a medication used primarily to treat Parkinson’s disease. It doesn’t cure the condition, but it helps manage symptoms by boosting dopamine levels in the brain. Unlike other Parkinson’s drugs that replace dopamine directly, Eldepryl works by stopping the enzyme that breaks dopamine down - making the dopamine you still have last longer.
How Eldepryl Works in the Brain
Eldepryl is a type of drug called a monoamine oxidase-B (MAO-B) inhibitor. The brain uses dopamine to control movement, and in Parkinson’s, dopamine-producing cells slowly die off. As dopamine drops, symptoms like tremors, stiffness, and slow movement get worse.
Eldepryl blocks the MAO-B enzyme, which normally breaks down dopamine. By slowing that breakdown, more dopamine stays active in the brain. This helps smooth out motor control without flooding the system with extra dopamine like levodopa does. That’s why Eldepryl is often used early in Parkinson’s - it can delay the need for stronger medications.
It’s also sometimes added to levodopa therapy later on. When levodopa starts wearing off faster between doses, Eldepryl can help extend its effect. Patients report fewer ‘off’ periods - times when symptoms return before the next pill kicks in.
Who Takes Eldepryl?
Eldepryl is approved for adults with Parkinson’s disease, especially those in the early stages. Doctors often prescribe it when symptoms are mild but starting to interfere with daily life - like trouble buttoning shirts, walking slowly, or having a shaky hand.
It’s not used for other forms of tremor or movement disorders unless they’re tied to Parkinson’s. It’s also not recommended for people with severe liver disease or those taking certain antidepressants, especially SSRIs or SNRIs, because of the risk of serotonin syndrome - a rare but dangerous reaction.
Eldepryl comes in tablet form and is usually taken once or twice a day, often in the morning. Taking it later in the day can cause trouble sleeping because it mildly stimulates the nervous system. The typical starting dose is 5 mg per day, and it may be increased to 10 mg if needed. Some patients take it as a once-daily 10 mg tablet, while others split it into two 5 mg doses.
Side Effects and Risks
Most people tolerate Eldepryl well, but side effects can happen. The most common ones include:
- Insomnia or trouble sleeping
- Dizziness or lightheadedness
- Dry mouth
- Nausea
- Headache
- Confusion or hallucinations (rare, but more likely in older adults)
At higher doses - above 10 mg per day - Eldepryl starts to affect MAO-A too, which breaks down serotonin and tyramine. That’s why doses above 10 mg require dietary restrictions. You must avoid foods high in tyramine, like aged cheeses, cured meats, tap beer, and fermented soy products. Eating these while on high-dose Eldepryl can cause a sudden, dangerous spike in blood pressure.
That’s why most doctors stick to the 10 mg daily limit. At that dose, dietary restrictions aren’t needed. The drug stays selective for MAO-B, and the risk of tyramine reactions is very low.
Eldepryl vs. Other Parkinson’s Medications
Eldepryl isn’t the only option for Parkinson’s. Here’s how it compares to other common treatments:
| Medication | How It Works | Best For | Key Limitations |
|---|---|---|---|
| Eldepryl (selegiline) | Blocks dopamine breakdown | Early-stage Parkinson’s, delaying levodopa use | Can cause insomnia; not for severe liver disease |
| Levodopa/Carbidopa | Replaces dopamine | More advanced symptoms | Wearing off, dyskinesias over time |
| Rasagiline (Azilect) | Also an MAO-B inhibitor | Similar to Eldepryl, once-daily dosing | More expensive; similar side effects |
| Pramipexole (Mirapex) | Dopamine agonist | Early-stage, reduces motor fluctuations | Can cause impulse control issues, swelling |
| Amantadine | Reduces dyskinesias; mild dopamine boost | For movement side effects from levodopa | Less effective for core symptoms |
Eldepryl is one of the oldest MAO-B inhibitors still in use. Rasagiline (Azilect) is a newer alternative with similar effects and a simpler dosing schedule - one pill a day, no splitting. But Eldepryl is often cheaper, especially as a generic. Many patients start with Eldepryl because it’s proven, affordable, and has decades of real-world data behind it.
What Happens If You Stop Taking Eldepryl?
Don’t stop Eldepryl suddenly. While it doesn’t cause physical dependence like opioids, stopping abruptly can make Parkinson’s symptoms bounce back harder. You might notice your tremors return faster or your movements feel stiffer than before.
If you need to stop - maybe because of side effects or surgery - your doctor will usually lower the dose slowly over a week or two. This helps your brain adjust without a sharp drop in dopamine activity.
Some patients wonder if Eldepryl slows Parkinson’s progression. Early studies suggested it might have neuroprotective effects, but later research hasn’t confirmed this. It helps manage symptoms - but it doesn’t stop the disease from getting worse over time.
Drug Interactions to Watch For
Eldepryl can interact with many other drugs. Always tell your doctor about everything you take - including over-the-counter meds, supplements, and herbal products.
- Antidepressants: SSRIs (like sertraline), SNRIs (like venlafaxine), and tricyclics can cause serotonin syndrome when mixed with Eldepryl. This can lead to high fever, rapid heartbeat, confusion, and muscle rigidity - a medical emergency.
- Decongestants: Pseudoephedrine and phenylephrine can raise blood pressure when taken with Eldepryl.
- Other Parkinson’s drugs: Combining Eldepryl with other MAO inhibitors or dopamine agonists needs careful monitoring.
- Meperidine (Demerol): This painkiller can cause life-threatening reactions with Eldepryl. Avoid it completely.
If you’re on any of these drugs, your doctor may switch you to a different Parkinson’s treatment or adjust doses carefully. Never start or stop anything without talking to your provider.
Real-Life Use: What Patients Say
Many people on Eldepryl report subtle but meaningful improvements. One 68-year-old man started it after being diagnosed with mild Parkinson’s. He noticed his handwriting became steadier and he didn’t need to take his first levodopa dose as early in the morning. He said, ‘It didn’t make me feel young again, but it gave me back a few quiet hours each day.’
Another woman in her early 70s started Eldepryl after her tremor began interfering with cooking. She had trouble holding a spoon. After four weeks, she said, ‘I could pour coffee without spilling.’ She didn’t feel ‘cured,’ but she felt more in control.
Not everyone responds the same. Some notice no change at all. Others get side effects like trouble sleeping and stop taking it. That’s why doctors often start low and go slow - to find the right fit for each person.
Is Eldepryl Right for You?
Eldepryl is a good option if:
- You’re in the early stages of Parkinson’s
- You want to delay starting levodopa
- You’re looking for an affordable, well-studied medication
- You don’t have liver problems or take antidepressants
It’s probably not the best choice if:
- You have severe liver disease
- You’re already on an SSRI or SNRI
- You have trouble sleeping or get anxious easily
- Your symptoms are advanced and you need stronger dopamine replacement
It’s not a magic pill. But for many, it’s a quiet, reliable tool that helps them live better with Parkinson’s - without big side effects or high costs.
Is Eldepryl a cure for Parkinson’s disease?
No, Eldepryl is not a cure. It helps manage symptoms by increasing dopamine activity in the brain, but it doesn’t stop the underlying nerve cell loss that causes Parkinson’s. It’s a treatment, not a solution.
Can I take Eldepryl with my antidepressant?
Not safely without close supervision. Mixing Eldepryl with SSRIs, SNRIs, or tricyclic antidepressants can cause serotonin syndrome - a dangerous condition with symptoms like high fever, confusion, fast heart rate, and muscle stiffness. Always tell your doctor what you’re taking.
Do I need to change my diet while taking Eldepryl?
Only if you’re taking more than 10 mg per day. At the standard 10 mg daily dose, dietary restrictions aren’t needed. But if your doctor increases your dose, you’ll need to avoid aged cheeses, cured meats, tap beer, and fermented foods to prevent dangerous blood pressure spikes.
How long does it take for Eldepryl to work?
Most people notice small improvements in movement or energy within 2 to 4 weeks. Full effects can take up to 6 to 8 weeks. It’s not fast-acting like a painkiller - it’s designed to build up gently over time.
Can Eldepryl cause hallucinations?
Yes, especially in older adults or those with advanced Parkinson’s. Hallucinations are rare at low doses but can happen. If you see, hear, or feel things that aren’t there, tell your doctor right away. They may lower your dose or switch you to another medication.
Is there a generic version of Eldepryl?
Yes. The generic name is selegiline. Generic versions are widely available and much cheaper than the brand-name Eldepryl. They work the same way and are approved by the FDA.
