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Inhibition of the enzyme monoamine oxidase-B, which in turn leads to a reduction in the formation of toxic free radicals.

Stimulation of superoxide dismutase, a powerful naturally occurring enzyme in the body that also destroys free radicals.

This dual antioxidant action likely underlies selegiline's action in delaying functional decline in Alzheimer's disease.

Giving selegiline to mice leads to a higher density of nerve fibers in the frontal cortex and hippocampus.

Mice given selegiline at about twenty-four months of age can increase, even double, their life expectancy beyond that point. In those studies, the mice demonstrated improved intelligence, measured by the ability to negotiate complex mazes and to develop a strategy to escape from water tanks. Experiments in dogs showed similar, but less robust, effects.

Obviously, taking selegiline will not double your life span as it can in mice, but its broad antiaging effects are a plus. Overall, the weight of the evidence suggests that it may be useful in preventing age-related memory loss.

Taking Selegiline to Prevent Memory Loss

Selegiline can cause insomnia, so it should be taken in the morning as a single daily dose. The usual dose range is 5 to 15 mg daily, though it can be given up to 60 mg per day to healthy people without any major side effects. Selegiline's action in inhibiting monoamine oxidase-B can make it toxic, but only in very high doses. Some physicians themselves use selegiline as an antiaging treatment. However, even among this group of people who can easily obtain medications, vitamin E is more popular. I have included selegiline as a second-level option in the Memory Program. Unlike vitamin E, selegiline is a prescription medication.

Vitamin E and Selegiline (Deprenyl)

My colleague Dr. Mary Sano headed a national consortium that compared four treatment conditions: vitamin E, selegiline (also called Deprenyl), vitamin E plus selegiline, and placebo to treat three hundred outpatients with early to midstage Alzheimer's disease. They found that both vitamin E 2,000 IUs daily (a high dose) and selegiline helped delay functional deterioration or nursing home placement by six months to a year. The results were published in the New England Journal of Medicine in 1997. Vitamin E alone, selegiline alone, and the combination of vitamin E and selegiline each delayed functional decline more than placebo. It was as if the antioxidant effect was "maxed out" by either compound, and hence adding them together did not improve matters any further.

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