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My PDR is of 1992 vintage and only Prozac is listed. The other SSRI drugs of Paxil and Zoloff are not listed. SSRI stands for Selective Serotonin Reuptake Inhibitors. In effect they slow the metabolizim of serotonin which increases the level of this neurotransmitter in the brain. For a long time it has been know that serotonin was low in PD. Little was done about it because the deficiency in dopamine was so obvious. Patients seemed to do so well on levodopa therapy that little was done about the reduced levels of serotonin. It is believed that reduced levels of serotonin are a possible cause of depression. In early articles on MPTP induced PD, something like 95% of the substantia nigra was destroyed in primates and still no PD symptoms were evident. As soon as the serotonin level lowered, the PD symptoms appeared. Now serotonin is used in the natural production of dopamine. Since there is a lack of production of dopamine in PD one would think there would be an excess of serotonin. There isn't and I do not know why. But to complicate the picture, carbidopa, I am told, acts as an inhibitor of the production of serotonin outside of the blood brain barrier. This may account for loss of theraputic value of carbidopa/levodopa when carbidopa gets above 300 mg daily. (I had a member taking 30 of the 25/100 sinemet pills daily. He is now on Permax, about 2 mg daily and cut his sinemet to around 8 25/100 pills daily). What this all comes around to say: Depression is more than a symptom of cronic illness in PD. It is part of PD and should be treated just like tremor, etc. The SSRI drugs make some sense because they increase the level of serotonin which is low. The SSRI drugs are contraindicted if someone is also on a MAO inhibitor. Your drugist will tell you that they will need to talk to your physician to make them aware that they prescribed a drug that was contraindicated with Eldepryl. As it turns out, if the level of Eldepryl is equal or less than 10 mg daily, there should be no problems. I take 5 mg of Eldepryl and Paxil without problems. I know many using Zoloff, Paxil and Prozac along with Eldepryl (<= 10 mg daily) who are not experiencing problems. Please check with your physician should you decide to try one of these drugs. By the way, all the bad publicity given Prozac is NOT FROM PD Patients. It is from wackos!!! I know some neurologists who believe SSRI drugs are as important as Sinemet. For me, Paxil, takes the edge off the day. Makes me nicer on the phone, a better listener, more agreeable, you might say, a nice guy (this is from my wife, so I wonder what I am like without Paxil). It also seems to help me sleep. There is one known side effect. The SSRI drugs are known to block sexual climax. I didn't say, block sexual drive, just climax. Some patients consider them a form of "birth control". I will let you read into this what ever you want. Well, that is enough on this subject. I would suggest those wanting more than "I read recently" should look at recent publications for more information. Regards, Alan Bonander ([log in to unmask]) PS: My neurologist has suggested that Paxil be put in the US water supply. It is that safe and we would substantically reduce the crime in this country. (All this was said with humor.)