Older Drugs Better at Beating Parkinson's Depression
Posted on: Thursday, 18 December 2008, 11:50 CST
An older class of antidepressants may be better at treating depression in Parkinson's disease patients than newer drugs on the market.
In the largest study of its kind to compare different antidepressants in these patients, researchers from the Robert Wood Johnson Medical School in Piscataway, N.J., found people were five times more likely to respond to the tricyclic antidepressant nortriptyline than they were to the serotonin-based drug paroxetine CR.
The difference probably lies in the fact that the older medications target both serotonin and norepinephrine, two receptors in the brain that help control mood and depression. The newer drugs just target serotonin.
Study author Matthew Menza, M.D., believes these results raise important issues regarding depression in Parkinson's disease.
"First, that people with Parkinson's disease can respond to antidepressants," he was quoted as saying. "This is important because depression in Parkinson's disease is underrecognized, underappreciated and undertreated. Commonly, the attitude is, of course you're depressed, you have a serious illness. This study shows that patients should have hope that they can be helped."
Secondly, "the study suggests that we may need to use medications that affect both serotonin and norepinephrine, not just serotonin, in the brain to be successful in treating depression related to Parkinson's disease."
However, Dr. Menza went on to note tricyclic antidepressants must be prescribed with caution since they carry an increased risk of overdose and death.
"People on a tricyclic antidepressant should have their dosages monitored closely by their doctor," he said.
SOURCE: Neurology, published online December 17, 2008
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