The Parkinson's Disease Research Group of the United Kingdom (84) reported an increased mortality rate in PD patients randomized to levodopa and selegiline, compared to levodopa alone. Forty-four (17.7%) deaths were observed in the lev-odopa group compared with 76 (28%) deaths in the levodopa plus selegiline group, after a mean duration of 5.6 years (P = 0.05). Methodologic questions were raised (85), and both groups had higher than expected mortality rates. Other studies have not reported higher mortality with selegiline. Analysis of the DATATOP trial and subsequent open-label extensions revealed an overall death rate of 17.1% (137 of 800), or 2.1% per year through a mean of 8.2 years of observation (86), and mortality rate was not affected by any of the treatments. Cumulative exposure to selegiline was not associated with increased mortality in the 13-year follow-up of the
DATATOP cohort (87). Overall, there is no definitive evidence linking selegiline use to increased mortality.
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