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Old 10-14-2017, 10:19 PM
dan1000 dan1000 is offline
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Join Date: Jul 2016
Posts: 34
5 yr Member
dan1000 dan1000 is offline
Junior Member
 
Join Date: Jul 2016
Posts: 34
5 yr Member
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Quote:
Originally Posted by alreadybutnotyet View Post
Hello,

I'm currently taking 1 mg tablet of Azilect every morning when I wake up. I'd like to get off of it. Is there a particular weaning schedule that is safe? Has anyone weaned off successfully?
When I stopped taking it, I simply stopped. No weaning needed (unlike, for example, pramipexole).

My understanding of the reason is this: Azilect is an irreversible MAO-B inhibitor. As such, it permanently disables MAO-B by binding to it, preventing it from binding to dopamine. When one stops taking Azilect, it takes many days for the body to replenish the bound MAO-B with newly formed unbound MAO-B (I seem to remember the replenishment rate being about 10% per day, so even after 1 week, about 30% of one's bound MAO-B would remain.

In other words, after quitting Azilect cold turkey, it takes 1 to 2 weeks for the body to replace the drug-affected MAO-B with fresh, unaffected MAO-B. That's long enough for all the body's chemical systems to adjust, hence no weaning needed.

Note: This analysis is for those taking Azilect for its dopaminergic effect, which is supposedly why most of us are prescribed it. But in reality, a lot of us are taking it for its purported neuroprotective effects (i.e.: the possibility that it slows the progression of the disease). The neuroprotective effect is controversial, and may not even be happening. But if it is happening, it is happening by a completely different mechanism of action than the dopaminergic mechanism of action. The neuroprotective mechanism of action is unknown - we simply don't know how or why it works. Therefore, it may be that the neuroprotective effect tapers off at a completely different rate than the dopaminergic effect.

Still, when I quit it, I quit it cold turkey, and didn't suffer any ill effects.

Note: Anyone who follows medical advice from a forum like this is a fool. Use the forum as input to help you formulate questions for your doctor. I'm not a doctor, so this post from me is merely input to help you come up with questions for your own doctor.

Dan
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