Selegiline for Health & Longevity - Quick Reference Sheet
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Selegiline for Health & Longevity

Created on 09/28/2026 – Quick Reference based on Evidence Review created using AI4L / Opus 5.5 – Audit

Selegiline, an inexpensive prescription medication for Parkinson's disease and, as a transdermal patch, depression, permanently blocks an enzyme that breaks down dopamine. Animal studies across several laboratories found longer average lifespan; no study has tested this in healthy people. Human evidence is strongest for depression and Parkinson's symptoms. Main low-dose risks are sleep disruption and dizziness on standing; serious reactions come mainly from drug combinations or higher doses. (Full Review)

Protocol

Longevity low dose (Life Extension Foundation)
5 mg twice weekly
Suggested by the Foundation; some advisors used 5 mg daily after age 45. No human dose has been validated for longevity.
Single or split dosing
One oral dose, daily or 2–3 times weekly
Permanent enzyme blocking allows intermittent dosing; Parkinson's regimens split 10 mg/day into morning and midday doses.
Time of day
Morning
Limits insomnia; consistent timing relative to food matters, as food raises absorption about threefold.
Time to effect
Mood (Patch)
1–2 weeks
Builds over 6 weeks
Parkinson's Symptoms
Within weeks
Symptom relief
Longevity
Not observable
Any longevity effect cannot be observed in an individual

Benefits

Contraindications
  • Opioid analgesics (meperidine, tramadol, methadone, tapentadol)
  • Other monoamine oxidase inhibitors (phenelzine, rasagiline, linezolid, intravenous methylene blue)
  • Antidepressants (fluoxetine, sertraline, venlafaxine, amitriptyline, mirtazapine, bupropion) with the patch; caution at low oral doses
  • Anticonvulsants (carbamazepine, oxcarbazepine) with the patch
  • Over-the-counter cough suppressant dextromethorphan
  • Within 14 days of stopping a contraindicated drug (5 weeks for fluoxetine) or of stopping selegiline
  • Pheochromocytoma
  • Children under 12 years (patch)
  • Uncontrolled hypertension (e.g., sustained blood pressure ≥160/100 mmHg)
  • Bipolar disorder without mood-stabilizer treatment, or a history of drug-induced mania
  • Active psychosis or current hallucinations
  • Pregnancy and breastfeeding
  • Severe liver impairment (Child-Pugh class C) or, for the orally disintegrating tablet, severe kidney impairment (creatinine clearance <30 mL/min)
  • Symptomatic orthostatic hypotension (systolic drop ≥20 mmHg on standing)
  • Elective surgery scheduled within 10 days
    •
Key Interactions
  • Oral contraceptives (ethinyl estradiol with levonorgestrel or gestodene): caution
  • Levodopa and dopamine agonists (carbidopa-levodopa, pramipexole, ropinirole): monitor
  • Prescription stimulants (amphetamine, methylphenidate): caution
  • Over-the-counter decongestants and diet aids (pseudoephedrine, phenylephrine): caution; avoid at non-selective doses
  • Serotonergic supplements (St John's wort, 5-hydroxytryptophan, L-tryptophan, S-adenosylmethionine): avoid
  • Phenylethylamine and sympathomimetic (adrenaline-like) supplements (phenylethylamine, bitter orange/synephrine, yohimbe, ephedra): avoid
  • Dopamine-precursor supplements (L-tyrosine, Mucuna pruriens, natural levodopa): monitor; additive effect
  • Blood-pressure-lowering supplements (hibiscus, aged garlic extract, beetroot nitrate): monitor; additive effect
  • Tyramine-rich foods (aged cheese, cured meats, tap beer, soy sauce): caution only above oral 10 mg/day or patch 6 mg/24 h
  • General anesthesia and elective surgery: caution
    •

Risk & Side Effects

  • High: Insomnia and overstimulation; hallucinations, confusion and agitation; orthostatic hypotension; dry mouth; application-site skin reactions
    •
  • Medium: Positive amphetamine drug screens; cardiac rhythm disturbances
    •
  • Low: Excess mortality; worsened levodopa dyskinesias; serotonin toxicity with serotonergic drugs; hypertensive reactions at higher exposure; impulse-control problems; melanoma signal in Parkinson's disease; suicidality in young adults; nausea
    •
  • Speculative: Shortened lifespan at excessive doses; stimulant misuse potential
    •

Monitoring

Marker Target Why
Seated blood pressure 110–120 / 70–80 mmHg Detect hypertension or hypotension
Orthostatic blood-pressure change Systolic drop <10 mmHg at 3 minutes standing Detect orthostatic hypotension
Resting heart rate 50–70 beats/min Detect stimulant effect or arrhythmia
ALT <25 U/L Liver function affects drug clearance
eGFR ≥90 mL/min/1.73 m² Kidney function affects metabolite clearance
PHQ-9 0–4 Track mood benefit and suicidality
MoCA 26–30 Track cognitive stability
Full-skin examination No new or changing pigmented lesions Melanoma surveillance

Cadence: Baseline before starting; blood pressure (lying and standing) and sleep at 2 weeks and 3 months, then every 6–12 months; liver and kidney panels, mood score and cognitive screen every 12 months; full-skin examination yearly

Qualitative Assessment

  • Sleep quality and time to fall asleep
  • Daytime energy and motivation
  • Mood stability and absence of irritability or anxiety
  • Lightheadedness on standing
  • Mental clarity and focus
  • Libido and absence of compulsive urges
Not medical advice. Educational distillation of a single evidence review. Confirm any decision with a qualified clinician, especially in the presence of prescription drugs or chronic conditions.