Objective: Parkinson’s Disease (PD) has primarily a motor feature consisting of rigidity, bradikinesia, and tremors with psychiatric manifestations like depression which is common, poorly understood, under recognized, and often ineffectively treated. Changes in serotonergic, noradrenergic and dopaminergic brain pathways have been hypothesized as the key neurochemical mechanism. The effects of older tricyclic antidepressant, SSRI’s and the newer drug like bupropion have been studied in PD. In these reports, depressive symptoms have been alleviated in about 50% of subjects with some improvement of motor symptoms also. No well-controlled studies comparing these antidepressants have been performed yet.
Design: Double blind randomized controls study with bupropion and sertaline in depression of Parkinson’s disease was carried on 46 patients of depression with PD.
Materials and Methods: 46 patients of PD having diagnosis of depression on DSM-IV criteria were randomized to six weeks of treatment with 100 mg of Sertaline and 300mg of Bupropion (23 patients each with two drugs). The efficacy measures were Hamilton Depression Rating Scale (HAMD), Clinical Global Impression Scale and Clinical Assessment of Improvement in motor symptoms of PD.
Results: Comparison of the changes from base line to end point revealed significantly greater improvement in both depressive as well as motor symptoms of PD with bupropion then with the sertaline on all three efficacy measures. Side effect profile with both the drugs was approximately equal.
Conclusion: Bupropion has both serotonin and dopamine reuptake inhibitory action; thus it provides more improvement in depressive as well as motor symptoms of PD and also suggest the role of dopamine in depression associated with PD.
Back to S014 Psychopathology with Parkinson's Disease vs. Parkinson's Disease with Psychopathology
Back to The Eleventh International Congress