Response (Ildiko Miklya)

Ildiko Miklya’s response to Samuel Gershon’s Comment on her reply to Ervin Varga’s comment on her essay on the History of Selegiline

Thank you Professor Gershon for commenting on my reply to Dr. Varga.  It was in 1979 when I started working in the Knoll Institute. Deprenyl was already used as an experimental tool in MAO research as the first selective inhibitor of B-type MAO. It was in 1977 when Birkmayer et al. demonstrated in their Lancet paper that deprenyl deserves attention as a unique therapeutic agent. Levodopa treatment in Parkinson’s disease had various side effects. Birkmayer and Hornykiewicz tried to achieve a levodopa-sparing effect by the concurrent administration of levodopa with an MAO-inhibitor. They were compelled to terminate this trial because the combination elicited hypertensive attacks. Since selegiline was the unique MAO inhibitor free of the cheese effect, Birkmayer combined selegiline with levodopa, and a levodopa-sparing effect was achieved in patients without side effects (Birkmayer et al., 1977). The levodopa-sparing effect of selegiline is related to the selective inhibition of B-type MAO. The Lancet Editorial “Deprenyl in Parkinson’s Disease” in 1982 catalyzed thereafter the widespread use of deprenyl in Parkinson’s disease. The antidepressant effect of deprenyl published first by Dr. Varga in 1965 was first confirmed by you in 1980. Your paper with Mann, published in Life Sciences appeared 15 years after the first Varga paper. Yours was the first study that confirmed the beneficial antidepressant effect of deprenyl in the West. But only in 2006 was deprenyl (Emsam) registered in the USA as an antidepressant. By now it is successfully used in therapy. In my reply to Dr. Varga’s comment, I tried to explain that in the early 1960s, when Professor Knoll developed deprenyl and clarified its unique pharmacological spectrum, this important discovery passed almost unnoticed. Only in the mid-1970s when the chances to develop personal contacts with colleagues in the West,  did opportunities for Hungarian scientists brightened. I feel honored  by and appreciate your informative comment .

Birkmayer W., Riederer P., Ambrozi L., YoudimM.B.H. Implication of combined treatment with “Madopar” and L-deprenyl in Parkinson's disease. Lancet 1:439-443


Mann D., Gershon S. A selective monoamine oxidase-B inhibitor in endogenous depression. Life Sciences, 1980; 26: 877-882

Varga E. Vorläufiger Bericht über die Wirkung des Präparats E-250 (phenyl-isopropyl-methyl-propinylamine-chlorhydrat). In: Dumbovich B. (Ed), III. Conferentia Hungarica pro Therapia et Investigatione in Pharmacologia, Akadémiai Kiadó (Publishing House of the Hungarian Academy of Sciences), Budapest, pp. 197-201


Ildiko Miklya

January 22, 2015