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Depression Medication for Parkinson’s

Depression Medication for Parkinson’sA new study shows that antidepressant drugs which only affect serotonin, often used as first-choice treatments, may not be best for depression in people with Parkinson’s disease.

The study is the first to compare an older antidepressant that targets two receptors in the brain with a newer generation serotonin-only-based drug and placebo. It is also the largest placebo-controlled study for Parkinson’s disease depression.

In the study, scientists gave 52 people diagnosed with Parkinson’s disease and depression either nortriptyline, a tricyclic antidepressant (TCA), paroxetine CR, a selective serotonin reuptake inhibitor (SSRI) or a placebo pill.

Depression affects up to 50 percent of people with Parkinson’s disease.

Tricyclics affect both norepinephrine and serotonin, two different receptors in the brain. The people were tested for improvement of depression symptoms at two, four and eight weeks after starting treatment.

The study found that the people who took nortriptyline were nearly five times more likely to see improvement in depression symptoms when compared with the people who took paroxetine CR.

“I think that this study shows a number of important things. First, that people with Parkinson’s disease can respond to antidepressants. This is important because depression in Parkinson’s disease is under-recognized, 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,” said study author Matthew Menza, MD.

“Second, 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.”

Menza also says that in addition to the older antidepressant, nortriptyline, that was tested in the study, there are newer medications that affect both serotonin and norepinephrine, and these need to be tested.

Tricyclic antidepressants are one of the older classes of antidepressants and have been used since the 1950s. Tricyclics have an increased risk of overdose and death due to toxic effects on the heart and brain.

“People on a tricyclic antidepressant should have their dosages monitored closely by their doctor,” said Menza.

The new research is published in the online issue of Neurology®, the medical journal of the American Academy of Neurology.

Source: American Academy of Neurology

Depression Medication for Parkinson’s

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Depression Medication for Parkinson’s. Psych Central. Retrieved on May 24, 2018, from https://psychcentral.com/news/2008/12/19/depression-medication-for-parkinsons/3533.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.