As a selective MAO-B inhibitor, the side effects of Rasagiline mainly involve the nervous and digestive systems, which can be alleviated through dose adjustment and preventive measures. Special attention should be paid to serious adverse reactions such as serotonin syndrome.

1. Common side effects and mitigation methods

(1) Neurological response

Headaches (17%) and dizziness (12%) often occur in the early stages of treatment and usually resolve on their own within 2-4 weeks. Suggest halving the initial dose and slowly titrating to the target dose.

(2) Gastrointestinal discomfort

Nausea (9%) and abdominal pain (6%) can be relieved by taking medication after meals. In severe cases, antiemetic drugs such as domperidone can be used in combination to avoid fasting.

2. Serious side effects requiring medical intervention

(1) 5-hydroxytryptamine syndrome

Manifested as high fever, muscle rigidity, and consciousness disorders, it is prohibited to use it in combination with SSRI/SNRI antidepressants. When it occurs, the medication should be stopped immediately and intravenous fluid should be administered to cool down.

(2) Hypertensive crisis

Co administration with foods containing casein (such as cheese and pickled products) may induce it, and strict low casein diet is required. Calcium channel blockers should be used for emergency treatment when blood pressure suddenly rises.

3. Precautions for special populations

(1) Patients with liver dysfunction

Child Pugh Class C patients are contraindicated, while Class B patients need to have their dosage halved (0.5mg/day). ALT/AST should be monitored monthly during treatment.

(2) Elderly patients

Patients over 65 years old have an increased risk of orthostatic hypotension. It is recommended to maintain a sitting position for 30 minutes after taking medication in the morning to avoid rapid changes in posture.