Azilect wean off
 

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

Azilect wean
 

Thanks for that info Dan. I would never follow advice like this from the internet. I was just curious to see if it was problematic or not. I have a checkup wth my doctor in a few weeks so I'll bring it up then.

Can you say why you want to stop Azilect? I stopped taking Seligiline back in January (same as Azilect but different brand name). I stopped because it drove my blood pressure up high but I have not been right since then. I will be seeing my neurologist this week and may consider asking for this med again. I'm not sure I will be able to give up all the foods that contain tyrosine which may be the reason the bp went so high.

For the last four months I've been on proprananol and carbidopa/levadopa. This combo did not work well for me.

Cold turkey here as well
 

We also quit taking Azilect without a wean-off schedule. We just didn't refill the prescription when it ran out.

Reason: were not seeing a benefit, and did not notice anything since quitting it (it's been long enough to notice).

I would get your doctor's approval before quitting, though, just to be safe.

I'm thinking of getting off of it for several reasons but it really just boils down to the fact that I'm just not seeing any "benefits", neuroprotective or otherwise, and having to manage all the side effects, food and drug interactions, etc, it's just not worth it to me.

I've been on Azilect for more than 8 years now and I haven't noticed anything that I could even remotely attribute to it.

My belief is that whether there is neuroprotective benefit or not is not currently known, or that it is suspected by some researchers, and doubted by others. Like you, I saw no symptomatic benefit. But as to neuroprotection - I'm not sure how any of us would tell.

Dan