Selegiline
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Selegiline is an irreversible MAO-B inhibitor used orally as adjunctive therapy in Parkinson disease and as a transdermal system for major depressive disorder. At recommended Parkinson doses it is relatively selective for MAO-B, but selectivity can diminish at higher exposures, increasing risks of hypertensive crisis and serotonergic drug interactions. The transdermal antidepressant product carries the antidepressant boxed warning for suicidal thoughts and behaviors in younger patients.
Exploratory record, not a reviewed medical publication.
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What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Selegiline is an irreversible MAO-B inhibitor used orally as adjunctive therapy in Parkinson disease and as a transdermal system for major depressive disorder. NutriStack rates the supporting evidence as strong. Common adult dosing is Oral Parkinson dosing is commonly 5 mg twice daily with breakfast and lunch, maximum 10 mg/day. Orally disintegrating tablets are typically 1.25-2.5 mg once daily before breakfast. Transdermal antidepressant dosing is 6 mg/24 hours once daily, with possible increases to 9 or 12 mg/24 hours., though a prescriber sets the actual dose. This profile indexes 3 sources.
The bottom line
Evidence rating strong. Most-documented uses: adjunctive treatment of parkinson disease in patients receiving levodopa/carbidopa, reduction in parkinson off time, treatment of major depressive disorder with the transdermal system. 3 sources indexed (1989–2025), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Selegiline irreversibly inhibits monoamine oxidase B, reducing dopamine metabolism in the brain and increasing dopaminergic activity in Parkinson disease. Transdermal dosing produces higher systemic selegiline exposure and antidepressant effects through broader central monoamine modulation while partly bypassing gut first-pass MAO-A inhibition at the lowest patch dose. Loss of MAO selectivity, serotonergic combinations, sympathomimetics, and tyramine-rich foods at higher-risk doses can produce severe toxicity.1,2
Dosing & protocol.
Oral capsules are usually taken with breakfast and lunch to reduce insomnia. Orally disintegrating tablets should be taken before breakfast without liquid. Dietary tyramine restriction is required for higher-dose transdermal patches and if MAO-A inhibition is clinically relevant.3
Full safety detail.
Side effects
- Nausea
- Dizziness
- Insomnia
- Orthostatic hypotension
- Dyskinesia or hallucinations when combined with levodopa
- Hypertensive reactions with tyramine or sympathomimetics
- Serotonin syndrome with serotonergic agents
- Application-site reactions with the patch
Contraindications
- Hypersensitivity to selegiline1,2
- Concomitant meperidine, tramadol, methadone, propoxyphene, cyclobenzaprine, dextromethorphan, St. John's Wort, or another MAOI2
- Concomitant serotonergic antidepressants unless a specialist-supervised washout is completed2
- Pheochromocytoma for the transdermal system3
- Children younger than 12 years for the transdermal system due to hypertensive crisis risk3
- High-tyramine foods must be avoided with 9 mg/24 hour and 12 mg/24 hour transdermal dosing and for 2 weeks after dose reduction or discontinuation from those doses3
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Randomized controlled trials
1- 1Effect of deprenyl on the progression of disability in early Parkinson's diseaseParkinson Study Group · New England Journal of Medicine · 1989
The DATATOP trial supported clinical benefit of deprenyl in early Parkinson disease, though interpretation included symptomatic effects.
Reference material
2- 2SELEGILINE HYDROCHLORIDE capsules, US Prescribing InformationURLU.S. National Library of Medicine · DailyMed · 2025
Labeling describes Parkinson indication, 10 mg/day dosing, loss of selectivity concerns, and serious reactions with meperidine and serotonergic drugs.
- 3EMSAM (selegiline transdermal system), US Prescribing InformationURLMylan Specialty L.P. · DailyMed · 2024
The transdermal label documents MDD dosing, suicidal thoughts boxed warning, contraindicated drugs, and tyramine diet requirements at 9 and 12 mg/24 hour doses.
Common questions.
Quick answers about Selegiline, drawn from the data on this page.
What is Selegiline?
Selegiline is an irreversible MAO-B inhibitor used orally as adjunctive therapy in Parkinson disease and as a transdermal system for major depressive disorder. At recommended Parkinson doses it is relatively selective for MAO-B, but selectivity can diminish at higher exposures, increasing risks of hypertensive crisis and serotonergic drug interactions. The transdermal antidepressant product carries the antidepressant boxed warning for suicidal thoughts and behaviors in younger patients.
What is Selegiline used for?
Commonly cited benefits of Selegiline include: Adjunctive treatment of Parkinson disease in patients receiving levodopa/carbidopa; Reduction in Parkinson off time; Treatment of major depressive disorder with the transdermal system. NutriStack rates the overall evidence as strong.
What is a typical dose of Selegiline?
A typical adult dose of Selegiline is Oral Parkinson dosing is commonly 5 mg twice daily with breakfast and lunch, maximum 10 mg/day. Orally disintegrating tablets are typically 1.25-2.5 mg once daily before breakfast. Transdermal antidepressant dosing is 6 mg/24 hours once daily, with possible increases to 9 or 12 mg/24 hours.. The commonly recommended form is Oral capsule or tablet for Parkinson disease; transdermal patch for major depressive disorder. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Selegiline?
Reported side effects include nausea, dizziness, insomnia, orthostatic hypotension, dyskinesia or hallucinations when combined with levodopa, hypertensive reactions with tyramine or sympathomimetics. This is educational information; check with a healthcare professional before use.
How strong is the evidence for Selegiline?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Selegiline in NutriStack.
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