As a psychiatrist I am gratified that there is a robust discusion regarding
the treatment of anxiety and depression in individuals suffering from
Parkinson Disease. This is an important topic, because these are common
symptoms, they respond nicely to appropriate medications, and treatment
reduces unnecessary suffering.
I feel compelled to disagree with a recent statement in the digest
encouraging the concommitant use of monoamine oxidase inhibitors (MAOIs) ie
Parnate, Nardil etc. and Prozac {an antidepressant from the selective
serotonin reupake inhibitors class, (SSRIs)}. Under no circumstances should
these medications be used together! They create a potential for a
"serotonergic" crisis, which can be sudden and life threatening.
Several years ago Deprenyl was introduced for treatment of P.D. Deprenyl is
a "mild" MAOI and for a while was thought to be compatible with SSRI
antidepressants. There are now reports of problems with this interaction as
well. Some people may use this combination, but I question the safety.
To most psychiatrists, this potentially lethal combination is quite evident.
Obviously many different types of specialists are treating the affective
symptoms of P.D. I think it would be ill advised to suggest this combination
of drugs. There are many different medications available without putting
your life at risk combining these medications.
