SOURCE: NewsRx.com and NewsRx.net
Pharma Investments, Ventures & Law Weekly
October 24, 2004, Pg. 220
HEADLINE: UNIVERSITY OF ROCHESTER;
Depression also a problem in patients with Parkinson disease
While Parkinson disease typically brings to mind symptoms such as
tremors
and slow movement, researchers have found that nearly half of all
Parkinson
patients also suffer from depression.
While it might seem natural that someone who has a disease such as
Parkinson
might become depressed, it's not so simple, said neurologist Irene
Richard, MD,
of the University of Rochester Medical Center.
"Many patients assume that it's normal to feel this way. They might
say, 'If
you had Parkinson's disease, you'd feel this way too.' That's not true.
If you
treat the depression, they'll still have the other symptoms of the
disease, but
they feel better. It's one aspect of the disease that may be very
treatable,"
said Richard.
"People diagnosed with other serious diseases that may also be
disabling,
such as rheumatoid arthritis, aren't nearly as likely to become
depressed."
Richard and coauthor William McDonald, MD, a psychiatrist at Emory
University, discussed the links between depression and movement disorders
like
Parkinson's disease in a review article in Neurology. In an article
titled, "Can
'blue' genes affect mood and movement?" the two noted that a team from
Columbia
University has linked a gene known to cause a movement disorder known as
dystonia with a type of early-onset depression. Now they and other
physicians
around the country are exploring possible links between mood and movement
in
other disorders such as Parkinson.
Of Parkinson patients who become depressed, about half have "major"
depression that has a significant impact on their lives, while others
have
milder forms of depression that are still distressing.
"There's a huge amount of suffering out there due to the depression
that
comes so frequently as part of Parkinson's disease," said Richard, who is
an
expert on the psychiatric aspects of the disease. Patients who have lost
the
pleasure they once took in activities or hobbies, or who are having
difficulty
sleeping or have a poor appetite, have common symptoms of depression.
"The depression is part of the illness, not simply a reaction to the
disease. We've found that if a physician brings up the topic, patients
will be
honest and will discuss their depression, but oftentimes they won't bring
it up
themselves. But depression is the No. 1 factor responsible for poor
quality of
life among these patients. We need to educate physicians to ask about
this in
their patients with Parkinson's disease," said Richard, an associate
professor
of neurology and psychiatry.
Doctors estimate that about 1 million people in North America have
Parkinson
disease, which targets a small group of cells in a part of the brain
known as
the substantia nigra that produce a chemical called dopamine. The loss of
these
brain cells results in abnormal signals to other parts of the brain,
which
Richard said appears to influence a person's mood. In addition, the
disease also
affects cells that produce brain chemicals such as serotonin and
norepinephrine,
which can play a role in depression.
Richard and McDonald are leading a national research study to test
the
effectiveness of antidepressants in treating some of the symptoms of
Parkinson
disease. The study will evaluate common antidepressant medications
paroxetine
(Paxil) and venlafaxine (Effexor) at treating the depression that
patients
experience. Richard said that until now, there hasn't been a large
placebo-controlled study to see how well antidepressant medications
actually
work in patients with Parkinson. The disease wreaks havoc in the brain
and may
cause such medications to work differently than they do in healthy
people.
The study will include 228 patients at 15 sites around the nation.
The
4-year, $4 million study is being funded by the National Institute of
Neurological Disorders and Stroke (Richard IH, McDonald WM, Can "blue"
genes
affect mood and movement? Neurology, 2004;63(4):610-1).
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