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Drugs Used to Combat Depression in Parkinson's Patients

Depression is just one of the big challenges facing patients diagnosed with Parkinson's disease. The 10 signs include prolonged sadness; crying; worrying in excess; lack of energy/increased fatigue; loss of interest in usual hobbies or activities; guilt, aches and pains; lack of motivation; feeling as though you are a burden to loved ones; dwelling on disability; dying and death. If you are experiencing any of these symptoms, talk to your doctor to see what types of treatment are available.

  1. The Facts

    • The Parkinson's Disease Foundation estimates that 40 percent of Parkinson's patients will battle depression at some point during the disease. This is partly because the disease affects many of the brain's areas that control mood like the area which manufactures serotonin, dopamine and norepinephrine (three important brain chemicals involved in the regulation of sleep, mood, energy, appetite and motivation). The disease also affects frontal lobe, which has important mood-regulating duties. Many of the popular antidepressants have shown promise in helping to alleviate depression symptoms by getting right to those damaged areas of the brain.

    SNRI Medications

    • Cymbalta (duloxetine) and Effexor/Effexor XR (venlafaxine) have shown promise in treating Parkinson's-related depression. The drugs belong to a class known as dual reuptake inhibitors (also called SNRIs) and work by increasing levels of serotonin and norepinephrine. The medication works by preventing these chemical from being reabsorbed into the cells of your brain. These medications also work to prevent your brain's anxiety and depression-oriented area from being as stimulated, thus helping to relieve anxiety and depression.

    SSRI Medications

    • Paxil (paroxetine), Zoloft (sertaline), Celexa (citalopram), Lexapro (escitalopram) and Prozac (fluoxetine) have also been effective in treating Parkinson's patients with depression. These medications are known as serotonin reuptake inhibitors (also called SSRIs), which effectively make serotonin more available for your brain's use. While the exact way that these drugs function to alleviate depression is not clear, it appears that they block your brain's ability to reabsorb serotonin (in certain nerve cells); thereby leaving more serotonin available. This effectively enhances the way that you brain sends nerve impulses and elevates mood.

    Tricyclic Medications

    • In December 2008, Dr. Matthew Menza, professor of Neurology and Psychiatry at Robert Wood Johnson Medical School in New Jersey, authored a report indicating that medication that affect norephinephrine and serotonin appear to be more effective than ones which affect serotonin alone. Nortriptyline, one of the older antidepressant medications known as tricyclics, has been estimated as being nearly five times more effective in alleviating depressive symptoms in Parkinson's patients. Perhaps this is because tricyclic medications affect three neurotransmitters in the brain, preventing serotonin, norepinephrine and dopamine from being reabsorbed.

    Additional Therapeutic Activities

    • Additional means of alleviating depression include ensuring that your disease is treated properly. Patients who experience uncontrolled on/off times and episodes of freezing are more likely to develop depression. Working with your doctor to best control your symptoms can help to decrease your burden and give you a sense of control. Regular exercise, a healthy diet and social interaction are all helpful in maintaining overall wellness. Additional psychological therapies like relaxation techniques, stress management and behavior therapy have all been effective in combating depression and offering patients overall coping mechanisms.

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