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Jonathan Blakeman-Shead wrote: > A few Questions for your PD page: > Perhaps you could explain the different types of depression associated with PD? > Is depression part of PD or an effect of PD.? > What is the chemistry of depression? > Are certain personality "types" more susceptible? I wasn't the one asked, but will butt in anyway with my own (layman's) thoughts, from my general file of PD symptoms: DEPRESSION: When a patient has PD, there is no guarantee of immunity from any other neurological dysfunction. Depression is very often diagnosed along with PD, and when found is considered to place the subject in a different category, for such purposes as a research program. I perceive two basic kinds of depression: so-called clinical depression, which is even more common in absence of PD, and the short-term mood swings that are exclusively related to PD. Clinical Depression: This illness is beyond the scope of the present discussion, except to say that it is now treatable very effectively in many cases by drugs alone. Unfortunately for PWP who also suffer clinical depression, some of those drugs have serious, potentially fatal, interaction with certain drugs used to treat PD. Clinical depression may be distinguished from the mood swings of PD by its very long development time, and of course by its lack of response to drugs used for PD. Mood swings, in contrast, are brief and sudden, and response to the usual antidepressant drugs may be disappointing. Mood Swings: The reason why cocaine, nicotine, and chocolate evoke psychological dependence is that they all contain elements that bind to dopamine receptors related to the sensation of pleasure. No surprise then, that dopamine itself has a similar effect. I'm not clear how the effect can be virtually instantaneous, since dopamine by mouth has to go a long way to enter the brain, but it's true. PWP in the fluctuation stage very often feel depressed as their levodopa dose nears exhaustion, and get a quick lift immediately on taking the next dose. This is so common that the onset of gloomy thoughts may serve as an indicator of the best dosage interval. It seems that many patients and doctors don't recognize the difference between this short-lived depression and true "clinical" depression, and therefore choose antidepressants such as Prozac or Zoloft, which may not be really needed. In contrast to clinical depression, the mood swings from fluctuating dopamine supply are not nearly so severe, and are quick to come and go. The depression may arrive within seconds, like a big wave on the seashore, and recede within a few more seconds, after taking the next scheduled dopamine-enhancing medication. -- J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks, CA 91403-5013