Zelapar is an MAO-type B inhibitor, which can increase monoamine (dopamine) levels in the brain and could therefore potentially reverse monoamine deficits in psychostimulant addicts. Transdermal Zelapar was tested in a double-blind, placebo-controlled trial in cocaine-dependent subjects which reported no superior effect of Zelapar to placebo on self-reported cocaine use or benzoylecgonine-free urine samples, which may suggest that MAO-B inhibitors may only have a limited application to treat psychostimulant addiction ( Elkashef et al., 2006 ). The related compound rasagiline, used for the treatment of Parkinson's disease, has not been tested in nonclinical or clinical pharmacological analyses.
Forms and Dosage
Zelapar is only available legally via prescription. It typically comes in the form of capsules, tablets, orally disintegrating tablets (ODTs), or the transdermal patch.
Zelapar capsules or tablets (Eldepryl) are normally taken twice per day, with meals. However, dosages vary, with the most common being two 5 mg pills per day .
The patch (Emsam) is available in 6, 9, or 12 mg strengths .
According to several researchers, Zelapar patches may have one major advantage over other forms of this medication, in that they appear to be associated with significantly fewer side-effects than other forms . However, your doctor will work with you to choose the form that makes the most sense for you, based on your particular medical history and needs.
In general, higher doses of Zelapar (6-20mg per day) are reported to be more effective at treating depression . However, there are many different factors that go into choosing dose size, and only your doctor has the necessary training to determine which dose size is best for any individual case.
Zelapar ( l -desprenyl) is a methamphetamine derivative and a potent, irreversible, MAO-B selective inhibitor primarily used for the treatment of Parkinson’s disease. 54,55 Because it is often cons >l -amphetamine (20-60% in urine) and l -methamphetamine (9-30% in urine). 55
In the canine model of narcolepsy, Zelapar (2 mg/kg oral administration) was demonstrated to be an effective anticataplectic agent, but this effect was found to be mediated by its amphetamine metabolites rather than via MAO-B inhibition. 56 Several trials in human narcolepsy have demonstrated a good therapeutic efficacy of Zelapar on both sleepiness and cataplexy with relatively few side effects. 57,58 Ten mg of Zelapar daily has no effect on the symptoms of narcolepsy, but 20 to 30 mg improves alertness and mood, and reduces cataplexy, showing an effect comparable to d -amphetamine at the same dose. Zelapar may be an interesting alternative to the use of more classical stimulants, as its potential for abuse has been reported to be very low.
Zelapar and ADHD
Although Zelapar has not been officially FDA-approved for this purpose, it is not uncommon for doctors to prescribe this medication in order to help improve or control the symptoms of ADHD.
The main rationale for using Zelapar in this way stems from its potential to increase dopamine levels throughout the brain. One of dopamine’s many important functions is to promote attention and focus. Additionally, low levels of dopamine in certain specific parts of the brain are believed to be responsible for some of the attention problems frequently seen in ADHD .
Although the evidence for this use of Zelapar is not quite as strong as it is for Parkinson’s and depression, there is still considerable scientific support behind its use in ADHD. For example, in a double-blind randomized controlled trial in 11 children with ADHD, Zelapar was reported to improve sustained attention, learning, and peer interactions, while also reducing hyperactivity .
Similarly, in different two double-blind randomized controlled trials with 40 and 28 children each, this drug was reported to be as effective as methylphenidate (a central nervous system stimulant, commonly sold as Ritalin) in improving the symptoms of ADHD. Better yet, Zelapar was also reported to cause fewer side effects .
However, at least one study contradicts some of this evidence: in one study of 24 adults with ADHD, Zelapar was reported to be no more effective than placebo in improving ADHD symptoms .
Rated Zelapar for Depression Report
This has been the best antidepressant and I haven't had any horrible side effects that you can experience with some drugs.
No specific information is available about clinically significant overdoses with ELDEPRYL (Zelapar hcl) . However, experience gained during Zelapar's development reveals that some individuals exposed to doses of 600 mg of d,l-Zelapar suffered severe hypotension and psychomotor agitation.
Since the selective inhibition of MAO B by Zelapar hydrochloride is achieved only at doses in the range recommended for the treatment of Parkinson's disease (e.g., 10 mg/day), overdoses are likely to cause significant inhibition of both MAO A and MAO B. Consequently, the signs and symptoms of overdose may resemble those observed with marketed non-selective MAO inhibitors .
I eat a vegetarian diet, no sugar and small meals, yet I have gained about 15 lbs since starting Zelapar about 1 1/2 years ago.
How to use Zelapar Hcl
Take this medication by mouth, usually twice daily with breakfast and lunch. Taking Zelapar late in the day may cause trouble sleeping. Dosage is based on your medical condition and response to therapy. Do not increase your dose or take it more often than directed.
After you have been taking Zelapar for 2 or 3 days, your doctor may direct you to lower your levodopa dose. Follow your doctor's instructions closely. Do not stop or change the dose of any of your medications without first talking with your doctor.
It may take a few weeks for the full benefits of the drug to be noticed. Do not stop taking this drug without first consulting your doctor. Talk with your doctor if the medication stops working well or if your condition worsens.
Why is this medication prescribed?
Zelapar is used to help control the symptoms of Parkinson's disease (PD; a disorder of the nervous system that causes difficulties with movement, muscle control, and balance) in people who are taking levodopa and carbidopa combination (Sinemet). Zelapar may help people with Parkinson's disease by decreasing the dose of levodopa/carbidopa needed to control symptoms, stopping the effects of levodopa/carbidopa from wearing off between doses, and increasing the length of time that levodopa/carbidopa will continue to control symptoms. Zelapar is in a group of medications called monoamine oxidase type B (MAO-B) inhibitors. It works by increasing the amount of dopamine (a natural substance that is needed to control movement) in the brain.
What Are Side Effects Associated with Using Zelapar (Zovirax)?
Common side effects or health problems may include:
Other side effects of Zelapar include:
- Irregular heartbeats
- Extrapyramidal symptoms (muscle spasms, restlessness, muscle rigidity, slowness of movement, tremor, and jerky movements)
- Generalized pain
- High blood pressure (hypertension)
- Sleep problems (insomnia)
- Mood changes
- Dizziness on standing
- Urinary retention
- Runny or stuffy nose
- Back pain
- Mouth sores or ulcers
- Pain with swallowing
This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.
Avoid drinking alcohol while you are taking Zelapar.
While taking Zelapar and for 14 days after you stop, you must NOT eat foods that are high in tyramine, including:
- air dried meats, aged or fermented meats, sausage or salami (including cacciatore and mortadella), pickled herring;
- any spoiled or improperly stored beef, poultry, fish, or liver;
- beer from a tap, beer that has not been pasteurized;
- aged cheeses (such as blue, Swiss, cheddar, Parmesan, or Romano cheese);
- over-the-counter supplements or cough and cold medicines that contain tyramine;
- sauerkraut, soy beans, soy sauce, tofu, fava beans; or
- yeast extracts (such as Marmite).
Eating tyramine while you are using Zelapar can raise your blood pressure to dangerous levels which could cause life-threatening side effects. You should become very familiar with the list of foods to avoid while you are using Zelapar.
Zelapar may impair your thinking or reactions. Some people taking this medicine have fallen asleep during normal daytime activities such as working, talking, eating, or driving. You may fall asleep suddenly, even after feeling alert. Be careful if you drive or do anything that requires you to be alert.
Many drugs can interact with Zelapar, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Zelapar. Give a list of all your medicines to any healthcare provider who treats you.
It is not known whether Zelapar hydrochloride is excreted in human milk. Because many drugs are excreted in human milk, consideration should be given to discontinuing the use of all but absolutely essential drug treatments in nursing women.