Older Drugs Better at Fighting Depression in Parkinson's Patients

WEDNESDAY, 18 dec 2008-- Antidepressants that treat multiple brain receptors may be better at treating depression in people with Parkinson's disease than medications that block only the serotonin receptor, a new study says.

The report, published in the Dec. 17 online issue of Neurology, found that Parkinson's patients on the tricyclic nortriptyline were almost five times more likely to have their symptoms of depression improve than were those on paroxetine CR. Tricyclics affect the norepinephrine and serotonin receptors in the brain, whereas paroxetine CR is only a selective serotonin reuptake inhibitor (SSRI).

Up to half of all people with Parkinson's experience bouts of depression.

"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," study author Dr. Matthew Menza, a professor of psychiatry and neurology at the Robert Wood Johnson Medical School in Piscataway, N.J., said in an American Academy of Neurology news release.

Tricyclics are part of an older class of antidepressants, first used in the 1950s. They carry a higher risk of overdose and death because of the toxic effects they have on the heart and brain.

Newer medications that target both serotonin and norepinephrine should be tested, Menza said.