Selegiline itself has
neuroprotective and neuro-rescuing effects, but concern over the resulting levomethamphetamine's
neurotoxicity led to development of alternative MAOB inhibitors, such as
rasagiline, that do not produce toxic metabolites.[14][15]
Side effects
When the nasal decongestant is taken in excess, levomethamphetamine has potential
side effects. These would be similar to those of other decongestants.
Non-medicinal usage
As of 2006, there were no studies demonstrating "drug liking" scores of oral levomethamphetamine that are similar to racemic methamphetamine or dextromethamphetamine in either recreational users or medicinal users.[6]
In recent years, tighter controls in Mexico on certain methamphetamine precursors like
ephedrine and
pseudoephedrine has led to a greater percentage of illicit meth from Mexican
drug cartels consisting of a higher ratio of levomethamphetamine to dextromethamphetamine within batches of racemic meth.[16][17]
Detection in body fluids
Levomethamphetamine can register on urine drug screens as either methamphetamine, amphetamine, or both, depending on the subject's metabolism and dosage. L-methamphetamine metabolizes completely into L-amphetamine after a period of time.[18]
Notes
^Other names include levmetamfetamine (
INN), l-methamphetamine, levodesoxyephedrine, and l-desoxyephedrine.
^It is a selective MAOB inhibitor at normal clinical doses. MAOB is an enzyme that metabolizes dopamine, the neurotransmitter deficient in Parkinson's Syndrome.
^
abMendelson J, Uemura N, Harris D, Nath RP, Fernandez E, Jacob P, et al. (October 2006). "Human pharmacology of the methamphetamine stereoisomers". Clinical Pharmacology and Therapeutics. 80 (4): 403–420.
doi:
10.1016/j.clpt.2006.06.013.
PMID17015058.
S2CID19072636.
^
abcPauly RC, Bhimani RV, Li JX, Blough BE, Landavazo A, Park J (March 2023). "Distinct Effects of Methamphetamine Isomers on Limbic Norepinephrine and Dopamine Transmission in the Rat Brain". ACS Chemical Neuroscience: acschemneuro.2c00689.
doi:
10.1021/acschemneuro.2c00689.
PMID36976755.
S2CID257772503.
^"Levmetamfetamine". PubChem. National Center for Biotechnology Information, U.S. National Library of Medicine.
Archived from the original on 18 October 2014. Retrieved 17 October 2014.
^
abMelega WP, Cho AK, Schmitz D, Kuczenski R, Segal DS (February 1999). "l-methamphetamine pharmacokinetics and pharmacodynamics for assessment of in vivo deprenyl-derived l-methamphetamine". The Journal of Pharmacology and Experimental Therapeutics. 288 (2): 752–758.
PMID9918585.
^
abMendelson J, Uemura N, Harris D, Nath RP, Fernandez E, Jacob P, et al. (October 2006). "Human pharmacology of the methamphetamine stereoisomers". Clinical Pharmacology and Therapeutics. 80 (4): 403–420.
doi:
10.1016/j.clpt.2006.06.013.
PMID17015058.
S2CID19072636.
^Pray SW.
"Nonprescription Products to Avoid With Hypertension". uspharmacist.com.
Archived from the original on 30 October 2014. Retrieved 17 October 2014. Topical Nasal Decongestants Most topical nasal decongestants also carry the warning against unsupervised use with hypertension. This includes oxymetazoline (e.g., Afrin), phenylephrine (e.g., Neo-Synephrine), naphazoline (e.g., Privine), and l-desoxyephedrine/levomethamphetamine. When hypertensive patients request a nasal decongestant, the pharmacist can recommend several alternatives. Propylhexedrine (e.g., Benzedrex Inhaler) is not required to carry a warning against unsupervised use with hypertension and may be effective. Another option is the nasal strip (e.g., Breathe Right). When properly applied, the strip can open the nostrils slightly, and perhaps sufficiently to allow the patient to breathe without use of a pharmacologically active ingredient.
^EP 0344675, Hajicek J, Hrbata J, Pihera P, Brunova B, Ferenc M, Krepelka J, Kvapil L, Pospisil J, "Method for the production of selegiline hydrochloride.", published 6 December 1989, assigned to Spofa Vereinigte Pharma Werke.
^Kalász H, Magyar K, Szőke É, Adeghate E, Adem A, Hasan MY, et al. (1 January 2014). "Metabolism of selegiline [(-)-deprenyl)]". Current Medicinal Chemistry. 21 (13): 1522–1530.
doi:
10.2174/0929867321666131218094352.
PMID24350849.
^Cody JD (December 1993). "Metabolic Precursors to Amphetamine and Methamphetamine". Forensic Science Review. 5 (2): 109–127.
PMID26270078.
^Cody JT (May 2002). "Precursor medications as a source of methamphetamine and/or amphetamine positive drug testing results". Journal of Occupational and Environmental Medicine. 44 (5): 435–450.
doi:
10.1097/00043764-200205000-00012.
PMID12024689.
S2CID44614179.
^Tabakman R, Lecht S, Lazarovici P (January 2004). "Neuroprotection by monoamine oxidase B inhibitors: a therapeutic strategy for Parkinson's disease?". BioEssays. 26 (1): 80–90.
doi:
10.1002/bies.10378.
PMID14696044.