Safinamide and Mucuna pruriens are medical agents used to treat Parkinsonism disease (PD). Parkinsonism patients lack dopaminergic neurons, hence reduced dopamine production in the brain. Mucuna pruriens can be used by patients who are unable to afford the marketed preparations of Levodopa ( Teixeira et al., 2018; Cilia et al., 2017).
Safinamide and Mucuna pruriens exert their action via different mechanisms. Safinamide is a Mono Amine Oxidase –B (MAO- B) inhibitor. It increases Dopamine levels in the brain by selectively and reversibly inhibiting MAO-B. This consequently prevents metabolism of Dopamine hence increasing its concentration in the brain and eventually lowering the symptoms of PD. Mucuna pruriens on the other hand is a leguminous plant whose seeds contain very high levels of levodopa. Levodopa is the gold standard treatment of PD and it is a Dopamine precursor whereby once it’s in the peripheral circulation and has crossed the Blood Brain Barrier, it is acted on by DOPA Decarboxylase to form Dopamine hence increasing their levels in the brain ( Teixeira et al., 2018; Cilia et al., 2017).
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Treatment of PD with safinamide has shown promising results as the drug, mainly used as an “add-on” to L-Dopa, reduces the motor complications such as dyskinesia associated with L-Dopa use. Additionally, clinical evidence is available which states that use of 100mg/day of safinamide can improve motor symptoms when used in the initial stage of PD. For Mucuna pruriens , both low and high does have a positive patient outcome where there is no Signiant difference when safety and efficacy is compared to that of Levodopa ( Teixeira et al., 2018; Cilia et al., 2017).
Limitations associated with Mucuna pruriens therapy include its tolerability in the long term use. The safety levels of chronic intake of levodopa are not so promising with gastrointestinal disturbance being the most common dose limiting factor. The non-dopaminergic actions of safinamide are the main limitation associated with its use.
Considering the limitations of irreversible MAO inhibitors, and the fact that Safinamide is a reversible MAO –B inhibitor, further research in PD with cognitive and depression impairment as well as studies to provide evidence of its anti PD actions needs to be conducted. More studies of Mucuna pruriens’ safety profile as compared to that of pharmaceutically prepared Levodopa needs to be conducted ( Teixeira et al., 2018; Cilia et al., 2017).
