The link between Parkinson's Disease and depression has come to light more in the past 5 years or so. Researchers are finally beginning to notice that depression occurs in a large part of the PD population (estimates are 40-50%).
The exact reasons for why such a large portion of Parkinson's patients develop depression are not entirely known. It is thought that the biochemical alterations are a large culprit, but stess and psycho-social reasons probably play a role too. I am sure that people on hearing their diagnosis of PD are less than happy and may experience some level of depression for a while, but when does this depression cross the line from feeling down about a difficult disease into a clinical depression? Also, there is evidence that 12-37% of patients with depressive symptoms develop these symptoms prior to developing motor symptoms. Does this mean that the depression is mostly biochemical? I do not know.
How do you piece apart the chemical changes in a person's brain from the psycho-social or stress induced changes in someone's attitude or behavior? This is a question that I think will take years to answer, if it is able to be answered at all.
Since there is a large population of depression in PD you would think that treatments would be fairly well understood. That is not true at all and actually the opposite is closer to the truth. From the research I have read there are several anti-depressants that are possible for treatment, but none of them have significant research surrounding their use and efficacy in treating depression in Parkinson's. That being said, an anti-depressant may be the right choice for many patients. A motor disease specialist should be able to recommend some medications as possible treatments.
Besides anti-depressants a patient suffering from depression may want to consider other forms of treatments either jointly with anti-depressants or by themselves. Obviously qualified medical personnel should help the patient with any of these decisions. Some possibilities for treatments are: counseling, stress-management, relaxation techniques, coping strategies or support groups.
It is important to note that although Parkinson's is a difficult disease for all patients those with depression may suffer from a lower quality of life. It is important to work closely with the medical community to monitor the patient's mood and to help if warranted. Remember not all PD patients suffer from depression, but those that do may need help seeking treatment.
Showing posts with label depression. Show all posts
Showing posts with label depression. Show all posts
Monday, September 8, 2008
Friday, August 29, 2008
Pramipexole treatment for Parkinson's Disease
Pramipexole is a non-ergot dopamine agonist that has been used to treat Parkinson's for several years now. Researchers are now studying whether or not this drug has neuroprotective properties and if it could possibly be used to help treat depression in PD.
Before we get into the latest research I want to define what a 'non-ergot' vs. ergot dopamine agonist is. A dopamine agonist is a compound that binds directly to dopamine receptors in the brain and can help relieve symptoms of Parkinson's Disease. An ergot compound is one that is derived from the ergot fungus, while a non-ergot compound is not. Many of the older dopamine agonist drugs were ergot dopamine agonists and they have now been associated with an increased risk for valvular heart disease because of their ability to act on serotonin (5-HT) receptors within the heart. The non-ergot dopamine agonists are not associated with this risk and tend to be used more prevalently today. (Note: Do not start or stop taking any medications without talking to your doctor. The author of this blog is not a doctor and is not offering medical advice.)
Pramipexole has been used to treat the general symptoms of Parkinson's for several years. That fact is not what interested me in this drug though.
The fascinating part to me is that researchers are now testing if this drug has neuroprotective abilities which could thereby slow the clinical progression of Parkinson's. Obviously that would be wonderful news for the PD community. There is currently a study called PROUD (http://www.medicalnewstoday.com/articles/119308.php) taking place in the UK that is examining this question of neuroprotection using pramipexole. I will be watching for the results from this study.
Other research into pramipexole's uses that intrigues me is the study of whether or not pramipexole is able to help treat depression in Parkinson's. Since depression is estimated in 40-60% of PD patients and about 50% of these patients do not respond to the usual anti-depressants, news of a dopamine agonist having a positive effect in this area would be great. Researchers are studying the effect on depression by pramipexole alone and also as adjunctive therapy along with another anti-depressant. I am particularly interested in depression in Parkinson's as research seems to note that people with PD and depression have a lesser quality of life than those that remain more optimistic.
Disclaimer: I felt I needed to add an additional disclaimer to this post. I am not a doctor or a scientist and am not offering medical advice in this blog. I am merely offering up information that can be used by the PD community in the hopes of helping others. Please consult your doctor about any medical treatment questions you have.
Before we get into the latest research I want to define what a 'non-ergot' vs. ergot dopamine agonist is. A dopamine agonist is a compound that binds directly to dopamine receptors in the brain and can help relieve symptoms of Parkinson's Disease. An ergot compound is one that is derived from the ergot fungus, while a non-ergot compound is not. Many of the older dopamine agonist drugs were ergot dopamine agonists and they have now been associated with an increased risk for valvular heart disease because of their ability to act on serotonin (5-HT) receptors within the heart. The non-ergot dopamine agonists are not associated with this risk and tend to be used more prevalently today. (Note: Do not start or stop taking any medications without talking to your doctor. The author of this blog is not a doctor and is not offering medical advice.)
Pramipexole has been used to treat the general symptoms of Parkinson's for several years. That fact is not what interested me in this drug though.
The fascinating part to me is that researchers are now testing if this drug has neuroprotective abilities which could thereby slow the clinical progression of Parkinson's. Obviously that would be wonderful news for the PD community. There is currently a study called PROUD (http://www.medicalnewstoday.com/articles/119308.php) taking place in the UK that is examining this question of neuroprotection using pramipexole. I will be watching for the results from this study.
Other research into pramipexole's uses that intrigues me is the study of whether or not pramipexole is able to help treat depression in Parkinson's. Since depression is estimated in 40-60% of PD patients and about 50% of these patients do not respond to the usual anti-depressants, news of a dopamine agonist having a positive effect in this area would be great. Researchers are studying the effect on depression by pramipexole alone and also as adjunctive therapy along with another anti-depressant. I am particularly interested in depression in Parkinson's as research seems to note that people with PD and depression have a lesser quality of life than those that remain more optimistic.
Disclaimer: I felt I needed to add an additional disclaimer to this post. I am not a doctor or a scientist and am not offering medical advice in this blog. I am merely offering up information that can be used by the PD community in the hopes of helping others. Please consult your doctor about any medical treatment questions you have.
Monday, August 4, 2008
Cognitive Symptoms
Most of the discussion on Parkinson's deals with the motor symptoms. These symptoms are the easier to recognize and usually respond to dopamine agonists (replacements). There are, however, many cognitive symptoms as well. Some (but not all) of the cognitive symptoms are: memory loss, depression and dementia. These symptoms are not discussed as much, are definitely harder to research on the Internet and seem to be more poorly understood in general. Unfortuntately many of these symptoms do not respond to dopamine and need different intervention.
The research on the cognitive aspects seems much more limited to me and the research varies widely on the frequency of cognitive issues, their possible causes and their treatments. It is an area of the disease that truly needs more attention and research as these symptoms have direct effects on the quality of life for the PD patient and their families.
Here is one useful webpage that I ran across while researching this topic.
http://www.waparkinsons.org/edu_research/articles/Cognitive_Changes.html
The research on the cognitive aspects seems much more limited to me and the research varies widely on the frequency of cognitive issues, their possible causes and their treatments. It is an area of the disease that truly needs more attention and research as these symptoms have direct effects on the quality of life for the PD patient and their families.
Here is one useful webpage that I ran across while researching this topic.
http://www.waparkinsons.org/edu_research/articles/Cognitive_Changes.html
Subscribe to:
Posts (Atom)
Posts
