Selegiline (Deprenyl, Emsam) - How Long Does It Take to Work?

[m060mm]

For the most part people say two to three weeks to return to baseline MAO-B levels. Why can't we generalize the rate at which MAO-B is denatured?

Five milligrams is the near-universal starting dose for the first few weeks. I imagine most of the inhibition is achieved during this period. If we can estimate how long it takes for levels to normalize, why no estimates of an inhibition timeline?

 

[m060mm]

For that matter, why is it not front-loaded? Assuming the patient has experience with an MAOI, wouldn't aggressive (10-20mg) starting doses cause the intended effect sooner? You may have to restrict your diet for that brief period (debatable: especially if we consider transdermal or sublingual administration) but once you drop down to 5-10mg/day, your MAO-A would restore and your MAO-B would continue to be denatured.