>Others say parkinsonians shouldn't use SSRI's as they
exacerbate
>PD symptoms. What's the latest word. Also, what is the
difference
>between Prozac, Paxil, Zoloft.
Any of these meds can potentially (to a small degree) increase some of the
symptoms of PD. One paper in the British Journal of Psychiatry claimed the
Paxil (paroxetine) produced more of these symptoms than the other drugs. I
tend to agree with the article, although others (including the manufacturer)
dispute this finding. The differences between these drugs (and even newer
SSRIs like fluvoxamine) are subtle:
- Prozac (fluoxetine) sticks around in the body longer, so it's good for
patients that might forget to take a dose or two.
- Zoloft (sertraline) may be somewhat less likely to affect the blood levels
of other medications.
- Prozac and Luvox (fluvoxamine) seem to be better for anxiety and
obsessive-compulsive disorder.
- Prozac seems to have the least upset stomach as a side effect.
- Luvox tends to be mildly sedating, Prozac and Paxil tend to be mildly
stimulating and Zoloft is stimulating for about 80% of patients and sedating
for about 20%.
Overall, these drugs are very safe and very effective. There are many
advantages over the older (tricyclic) antidepressants like Elavil
(amitriptyline). There is no reason why a patient with PD should not take
them if prescribed by your doctor and if they do increase PD symptoms (as I
said, this is unlikely) they can be stopped.
I hope this info hasn't confused anyone even more.
mike
====================================================================
IMPORTANT DISCLAIMER:
All material presented here is for information purposes only and
is not intended to represent diagnosis, prescription of medications
or treatments, nor specific prescribing recommendations. The opinions
expressed here are those of the author alone and are not intended to
represent those of any organization or other individuals.
====================================================================
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Mahmood (Mike) A. Usman, M.D.
Director, Memory and Movement Disorder Programs
Medical College of PA & Hahnemann University, Allegheny Campus
e-mail: [log in to unmask] [log in to unmask]
Phone: (412) 330-4005 Fax: (412) 330-4089
4 Allegheny Center Pittsburgh, PA 15212 USA
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