Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

The significance of selegiline/(−)-deprenyl after 50 years in research and therapy (1965–2015)

Abstract

Deprenyl/Selegiline (DEP), created by Joseph Knoll in the 1960s, registered in more than 60 countries to treat Parkinson’s disease, Alzheimer’s disease, major depressive disorder; and used as an anti-aging drug, achieved its place in research and therapy as the first selective inhibitor of B-type monoamine oxidase (MAO-B). The demonstration that the DEP analog (−)-1-phenyl-2-propylaminopentane devoid of MAO inhibitory property, enhanced like DEP the activity of the catecholaminergic brain engine revealed that this effect is unrelated to the selective inhibition of MAO-B. β-Phenylethylamine (PEA), the important trace-amine in the mammalian brain, is known to be a releaser of catecholamines. Amphetamine and methamphetamine, the best known synthetic PEA derivatives are also releasers of catecholamines like their parent compound. DEP is a unique synthetic PEA derivative devoid of the catecholamine releasing property. As the releasing effect conceals the catecholaminergic activity enhancer (CAE) effect, it remained undiscovered until DEP uncovered that PEA is a natural CAE substance; and only releases catecholamines in high concentration. Discovering that tryptamine is a natural enhancer of catecholaminergic and serotonergic neurons catalyzed the development of R-(−)-1-(benzofuran-2-yl)-2-propylaminopentane (BPAP); the most potent and selective enhancer substance, and it exerts its enhancer effect in 0.0001 mg kg−1. DEP and BPAP initiated an analysis of the enhancer regulation in the mammalian brain. Studies regarding the nature of the enhancer regulation revealed that this regulation is enhanced after weaning and sex hormones return it to the pre-weaning level. Thus, sex hormones elicit the transition of the developmental phase of life into the post-developmental, downhill (aging) period. The aging-related, slow decline in the enhancer regulation of the catecholaminergic brain engine, the main activator of the cortex, is the prime factor of brain aging. The enhancer regulation’s decay in the most rapidly aging dopaminergic system is, for example, mainly responsible for the decline in learning ability and sexual activity over time. According to the Knoll concept, based on two longevity studies performed on male rats, to keep the catecholaminergic brain engine, from the beginning of the downhill period of life, via the administration of a small daily dose of a CAE substance (presently DEP is the only available drug) on a higher activity level, thus to fight against the physiological aging-related slow decay of the catecholaminergic system, is a suitable anti-aging therapy. As our present knowledge regarding the enhancer regulation in the mammalian brain is like seeing a peak of an iceberg, the future of this new line of brain research looks promising from both theoretical and practical aspects.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Knoll J, Ecseri Z, Kelemen K, Nievel J, Knoll B . Phenylisopropylmethyl propinylamine (E-250) a new psychic energizer. Arch Int Pharmacodyn Ther 1965; 155: 154–164.

    CAS  PubMed  Google Scholar 

  2. Varga E, Tringer L . Clinical trial of a new type of promptly acting psychoenergetic agent (phenyl-isopropylmethyl-propinylamine HCl, E-250). Acta Med Acad Sci Hung 1967; 23: 289–295.

    CAS  PubMed  Google Scholar 

  3. Tringer L, Haits G, Varga E. The effect of (-)E-250, (-)L-phenyl-isopropylmethyl- propinyl-amine HCl, in depression’. In: Leszkovszky G (ed). V. Conferentia Hungarica pro Therapia et Investigatione in Pharmacologia. Publishing House of the Hungarian Academy of Sciences: Budapest, Hungary, 1971, pp 111–114.

    Google Scholar 

  4. Mann JJ, Gershon S . A selective monoamine oxidase-B inhibitor in endogenous depression. Life Sci 1980; 26: 877–882.

    Article  CAS  Google Scholar 

  5. Bodkin JA, Amsterdam JK . Transdermal selegiline in major depression: a double-blind, placebo-controlled, parallel-group study in outpatients. Am J Psych 2002; 159: 1869–1875.

    Article  Google Scholar 

  6. Blackwell B . Hypertensive crisis due to monoamine oxidase inhibitors. Lancet 1963; ii: 849–851.

    Article  Google Scholar 

  7. Knoll J, Vizi ES, Somogyi G . Phenylisopropylmethylpropinylamine (E-250), a monoamine oxidase inhibitor antagonizing the effects of tyramine. Arzneim Forsch 1968; 18: 109–112.

    CAS  Google Scholar 

  8. Elsworth JD, Glover V, Reynolds GP, Sandler M, Lees AJ, Phuapradit P et al. Deprenyl administration in man: a selective monoamine oxidase B inhibitor without the ‘cheese effect’. Psychopharmacology 1978; 57: 33–38.

    Article  CAS  Google Scholar 

  9. Sandler M, Glover V, Ashford A, Stern GM . Absence of ‘cheese effect’ during deprenyl therapy: some recent studies. J Neural Transm 1978; 43: 209–215.

    Article  CAS  Google Scholar 

  10. Birkmayer W, Riederer P, Ambrozi L . Youdim MBH. Implications of combined treatment with ‘Madopar’ and L-Deprenil in Parkinson's disease. Lancet 1977; 1: 439–443.

    Article  CAS  Google Scholar 

  11. Knoll J, Magyar K . Some puzzling effects of monoamine oxidase inhibitors. Adv Biochem Psychopharmacol 1972; 5: 393–408.

    CAS  PubMed  Google Scholar 

  12. Birkmayer W, Hornykiewicz O . Der L-dioxyphenyl-alanin-effekt beim Parkinson syndrom des Menschen. Arch Psychiat Nervenkrh 1962; 203: 560–564.

    Article  CAS  Google Scholar 

  13. Harsing RG, Magyar K, Tekes K, Vizi ES, Knoll J . Inhibition by (-)-deprenyl of dopamine uptake in rat striatum: a possible correlation between dopamine uptake and acetylcholine release inhibition. Pol J Pharm Pharmacy 1979; 31: 297–307.

    CAS  Google Scholar 

  14. Knoll J . R-(-)Deprenyl (Selegiline, MoverganR facilitates the activity of the nigrostriatal dopaminergic neuron. J Neural Transm 1987; 25: 45–66.

    CAS  Google Scholar 

  15. Knoll J . The striatal dopamine dependency of lifespan in male rats. Longevity study with (-)deprenyl. Mech Ageing Dev 1988; 46: 237–262.

    Article  CAS  Google Scholar 

  16. Knoll J . Selective inhibition of B type monoamine oxidase in the brain: a drug strategy to improve the quality of life in senescence. In: Keverling Buisman JA (ed). Strategy in Drug Research. Elsevier: Amsterdam, Netherlands, 1982, pp 107–135.

    Google Scholar 

  17. Knoll J . The facilitation of dopaminergic activity in the aged brain by (-)deprenyl. A proposal for a strategy to improve the quality of life in senescence. Mech Ageing Dev 1985; 30: 109–122.

    Article  CAS  Google Scholar 

  18. Riederer P, Wuketich S . Time course of nigrostriatal degeneration in Parkinson's disease. J Neural Transm 1976; 38: 277–301.

    Article  CAS  Google Scholar 

  19. Fowler CJ, Wiberg A, Oreland L, Winblad B . The effect of age on the activity and molecular properties of human brain monoamine oxidase. J Neural Transm 1980; 49: 1–20.

    Article  CAS  Google Scholar 

  20. McGeer EG, McGeer PL, Wada JK . Distribution of tyrosine hydroxylase in human and animal brain. J Neurochem 1971; 18: 1647–1658.

    Article  CAS  Google Scholar 

  21. Birkmayer W, Knoll J, Riederer P, Youdim MB, Hars V, Marton J . Increased life expectancy resulting from addition of L-deprenyl to Madopar treatment in Parkinson's disease: a longterm study. J Neural Transm 1985; 64: 113–127.

    Article  CAS  Google Scholar 

  22. Knoll J, Dalló J, Yen TT . Striatal dopamine, sexual activity and lifespan. Longevity of rats treated with (-)deprenyl. Life Sci 1989; 45: 525–531.

    Article  CAS  Google Scholar 

  23. Knoll J . The pharmacology of selegiline /(-)deprenyl/. Acta Neurol Scand 1989; 126: 83–91.

    Article  CAS  Google Scholar 

  24. Carrillo MC, Kanai S, Nokubo M, Kitani K . (-)Deprenyl induces activities of both superoxide dismutase and catalase but not of glutathion peroxidase in the striatum of young male rats. Life Sci 1991; 48: 517–521.

    Article  CAS  Google Scholar 

  25. Knoll J . Memories of my 45 years in research. Pharmacol Toxicol 1994; 75: 65–72.

    Article  CAS  Google Scholar 

  26. Knoll J, Yen TT, Miklya I . Sexually low performing male rats die earlier than their high performing peers and (-)deprenyl treatment eliminates this difference. Life Sci 1994; 54: 1047–1057.

    Article  CAS  Google Scholar 

  27. Tetrud JW, Langston JW . The effect of (-)deprenyl (selegiline) on the natural history of Parkinson's disease. Science 1989; 245: 519–522.

    Article  CAS  Google Scholar 

  28. Parkinson Study Group. Effect of (-)deprenyl on the progression disability in early Parkinson's disease. New Eng J Med 1989; 321: 1364–1371.

    Article  Google Scholar 

  29. Knoll J . Pharmacological basis of the therapeutic effect of (-)deprenyl in age-related neurological diseases. Med Res Rev 1992; 12: 505–524.

    Article  CAS  Google Scholar 

  30. Knoll J . (-)Deprenyl-medication: a strategy to modulate the age-related decline of the striatal dopaminergic system. J Am Ger Soc 1992; 40: 839–847.

    Article  CAS  Google Scholar 

  31. Knoll J, Knoll B, Török Z, Timár J, Yasar S . The pharmacology of 1-phenyl-2-propylaminopentane (PPAP), a deprenyl-derived new spectrum psychostimulant. Arch Int Pharmacodyn Ther 1992; 316: 5–29.

    CAS  PubMed  Google Scholar 

  32. Miklya I, Knoll B, Knoll J . A pharmacological analysis elucidating why, in contrast to (-)-deprenyl (selegiline) α-tocopherol was ineffective in the DATATOP study. Life Sci 2003; 72: 2641–2648.

    Article  CAS  Google Scholar 

  33. Miklya I . The Knoll-concept to decrease the prevalence of Parkinson’s disease, Chapter 5. In: Finkelstein DI (ed). Towards New Therapies for Parkinson’s Disease. InTech Open Access Publisher: Rijeka, Croatia, 2011, pp 77–100.

    Google Scholar 

  34. Miklya I . Essential difference between the pharmacological spectrum of (-)-deprenyl and rasagiline. Pharmacol Rep 2014; 66: 453–458.

    Article  CAS  Google Scholar 

  35. Parkinson Study Group. A controlled trial of rasagiline in early Parkinson disease: the TEMPO study. Arch Neurol 2002; 59: 1937–1943.

    Article  Google Scholar 

  36. Knoll J, Tóth V, Kummert M, Sugár J . (-)Deprenyl and (-)parafluorodeprenyl-treatment prevents age-related pigment changes in the substantia nigra. A TV-image analysis of neuromelanin. Mech Ageing Dev 1992; 63: 157–163.

    Article  CAS  Google Scholar 

  37. Knoll J, Miklya I . Multiple, small dose administration of (-)deprenyl enhances catecholaminergic activity and diminishes serotoninergic activity in the brain and these effects are unrelated to MAO-B inhibition. Arch Int Pharmacodyn Ther 1994; 328: 1–15.

    CAS  PubMed  Google Scholar 

  38. Knoll J, Miklya I . Enhanced catecholaminergic and serotoninergic activity in rat brain from weaning to sexual maturity. Rationale for prophylactic (-)deprenyl (selegiline) medication. Life Sci 1995; 56: 611–620.

    Article  CAS  Google Scholar 

  39. Knoll J, Miklya I, Knoll B, Markó R, Rácz D . Phenylethylamine and tyramine are mixed-acting sympathomimetic amines in the brain. Life Sci 1996; 58: 2101–2114.

    Article  CAS  Google Scholar 

  40. Knoll J . How Selegiline /(-)-Deprenyl Slows Brain Aging. Bentham Science Publishers: E-book, Sharjah, United Arab Emirates, 2012.

    Book  Google Scholar 

  41. Martini E, Pataky I, Szilágyi K, Venter V . Brief information on an early phase-II study with (-)deprenyl in demented patients. Pharmacopsychiatry 1987; 20: 256–257.

    Article  CAS  Google Scholar 

  42. Tariot PN, Cohen RM, Sunderland T, Newhouse PA, Yount D . Mellow AM. L-(-)Deprenyl in Alzheimer's disease. Arch Gen Psych 1987; 44: 427–433.

    Article  CAS  Google Scholar 

  43. Sano M, Ernesto C, Thomas RG, Klauber MR, Schafer K, Grundman M et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease. New Eng J Med 1997; 336: 1216–1222.

    Article  CAS  Google Scholar 

  44. Wilcock GK, Birks J, Whitehead A, Evans SJ . The effect of selegiline in the treatment of people with Alzheimer’s disease: a meta-analysis of published trials. Int J Geriatr Psychiatry 2002; 17: 175–183.

    Article  CAS  Google Scholar 

  45. Milgram NW, Ivy GO, Head E, Murphy PM, Wu PH, Ruehl WW et al. The effect of L-deprenyl on behavior, cognitive function, and biogenic amines in the dog. Neurochem Res 1993; 18: 1211–1219.

    Article  CAS  Google Scholar 

  46. Knoll J, Yoneda F, Knoll B, Ohde H, Miklya I . (-)l-(Benzofuran-2-yl)-2-propylaminopentane, [(-)BPAP], a selective enhancer of the impulse propagation mediated release of catecholamines and serotonin in the brain. Br J Pharmacol 1999; 128: 1723–1732.

    Article  CAS  Google Scholar 

  47. Knoll J, Miklya I, Knoll B . Stimulation of the catecholaminergic and serotoninergic neurons in the rat brain by R-(-)-1-(benzofuran-2-yl)-2-propylaminopentane, (-)-BPAP. Life Sci 2002; 71: 2137–2144.

    Article  CAS  Google Scholar 

  48. Knoll J, Miklya I, Knoll B, Dalló J . Sexual hormones terminate in the rat the significantly enhanced catecholaminergic/serotoninergic tone in the brain characteristic to the post-weaning period. Life Sci 2000; 67: 765–773.

    Article  CAS  Google Scholar 

  49. Knoll J . (-)Deprenyl (selegiline) a catecholaminergic activity enhancer (CAE) substance acting in the brain. Pharmacol Toxicol 1998; 82: 57–66.

    Article  CAS  Google Scholar 

  50. Knoll J . Antiaging compounds: (-)Deprenyl (Selegiline) and (-)1-(benzofuran-2-yl)-2-propylaminopentane, (-)BPAP, a selective highly potent enhancer of the impulse propagation mediated release of catecholamines and serotonin in the brain. CNS Drug Rev 2001; 7: 317–345.

    Article  CAS  Google Scholar 

  51. Knoll J . Enhancer regulation/endogenous and synthetic enhancer compounds: a neurochemical concept of the innate and acquired drives. Neurochem Res 2003; 28: 1187–1209.

    Article  Google Scholar 

  52. Knoll J . The Brain and Its Self. A Neurochemical Concept of the Innate and Acquired Drives. Springer: Berlin, Heidelberg, Germany, New York, USA, 2005.

    Google Scholar 

  53. Knoll J, Miklya I, Knoll B, Yasusa T, Shimazu S, Yoneda F . 1-(Benzofuran-2-yl)-2-(3,3,3-trifluoropropyl)aminopentane HCl, 3- F-BPAP, antagonizes the enhancer effect of (-)-BPAP in the shuttle box and leaves the effect of (-)-deprenyl unchanged. Life Sci 2002; 71: 1975–1984.

    Article  CAS  Google Scholar 

  54. Knoll J . The Theory of Active Reflexes. An analysis of Some Fundamental Mechanisms of Higher Nervous Activity. Hafner Publishing Company: New York, USA, 1969.

    Google Scholar 

Download references

Acknowledgements

The author of this paper, one of his coworkers, who was lucky to join his staff 35 years ago and still has the privilege to work with him daily in his lab, congratulates Professor József Knoll, a pioneer of neuro-psychopharmacology, on his 90th birthday. There can be little doubt that Professor Knoll’s life work summarized in his monographs40,52,54 provides the everlasting effort of science to improve the quality and duration of human life with a hopeful new basis.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to I Miklya.

Ethics declarations

Competing interests

The author declares no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miklya, I. The significance of selegiline/(−)-deprenyl after 50 years in research and therapy (1965–2015). Mol Psychiatry 21, 1499–1503 (2016). https://doi.org/10.1038/mp.2016.127

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/mp.2016.127

This article is cited by

Search

Quick links