Antidepressant helps cardplayer's tremor
NEW YORK, Sep 22, 1999 (Reuters Health) -- A chance observation that
mirtazapine (Remeron) -- a drug used to treat depression -- helped a
woman with tremor keep her hands steady as she played cards, has opened
up a new era in the potential treatment of movement disorders, predict
North Carolina neurologists.
Writing in the journal Neurology, Drs. Virginia Pact and Tom Giduz, both
in private practice at Chapel Hill Neurology in Chapel Hill, North
Carolina, report that five patients with tremor quickly improved after
taking 30 milligrams of mirtazapine.
``In most people it worked very quickly, and in one patient, the wife
called us the next morning to tell us (her husband's) tremor had only
lasted for 15 minutes,'' Pact told Reuters Health in an interview. The
five patients included in the report had a variety of tremors, some of
them severely affected.
The woman whose hands normally shook when she tried to play bridge, for
example, had mild Parkinson's disease, where the hands commonly shake
while resting and stop shaking when engaged in movement. Another patient
had ``action'' tremor, in which the hands shake, sometimes quite
violently, when people initiate movement such as reaching for a glass.
Several patients had advanced Parkinson's disease. An inevitable
consequence of the drugs used to treat Parkinson's disease is that they
cause tremor, which is not well controlled with other, currently
available medications. The investigators also observed that the tremor
returned when the patients stopped taking mirtazapine. Conversely, when
they resumed taking the medication, their tremor again improved or
disappeared.
``We don't really know why this medication improves tremor,'' said Pact.
As an antidepressant, mirtazapine increases the availability of several
types of brain chemicals including norepinephrine and serotonin.
But mirtazapine also has blocking qualities, Pact said, ''and we suspect
that it might be some of its blocking capabilities that improve
tremor.'' Pact also noted that they have now treated 10 additional
patients with tremor using the same drug. In seven of them, tremor has
similarly improved.
SOURCE: Neurology 1999;53:1154.
Copyright © 1996-1999 Reuters Limited.
--
Judith Richards, London, Ontario, Canada
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