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The dose of levodopa can be reduced and there is evidence that this combination has a neuroprotective effect and slows the progression of the disease. This may be because in Parkinsons disease, MAO-B is involved in the production of an endogenous neurotoxin. Combination therapy with levodopa also reduces end of dose deterioration. Side effects of MAO-B inhibitors include nausea, dry mouth, dizziness, postural hypotension, insomnia, confusion and hallucinations. Anti-cholinergic drugs were originally used prior to the development of levodopa because many signs of excessive parasympathetic activity are seen in Parkinsons patients (salivation, sweating and incontinence).

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