UCSF Neurologists Focus on Depression in Patients with Parkinson's

By Carol Hyman

Doctors have found that nearly half of all Parkinson's patients also suffer from depression, and many patients mistakenly assume that the condition is simply something they have to live with. Not so, say physicians at UCSF Medical Center, who are conducting a study to test the effectiveness of antidepressants in patients with the disease. The study of patients at UCSF is part of a nationwide study of 228 patients at 19 sites around North America. Doctors conducting the four-year study, funded by the National Institute of Neurological Disorders and Stroke, are testing whether the antidepressant medications paroxetine (brand name Paxil) and venlafaxine (brand name Effexor) are effective at alleviating the depression that many Parkinson's patients experience. It's the first large, placebo-controlled study testing how well antidepressant medications actually work in patients with Parkinson's. "Many people with Parkinson's disease are depressed, but are reluctant to seek treatment," says Chad Christine, MD, UCSF assistant clinical professor of neurology who is the principal investigator for the UCSF study. "Some patients believe it's just a matter of will to overcome depression, and others think it's just a normal response to being diagnosed with Parkinson's. We're saying that the depression is part of Parkinson's, and that there is treatment for it." UCSF has enrolled two patients, with a goal of enrolling 10 to 15 in this double-blind study. Patients will have eight clinic visits over a period of 12 to 14 weeks. They will be given either one of the two antidepressants or a placebo. Any Parkinson's patient over the age of 30 who is experiencing symptoms of depression is encouraged to enroll. Of Parkinson's patients who become depressed, about half have major depression that has a significant impact on their lives, while others have milder forms of depression that are still distressing, doctors say. Since many people who are depressed often have a difficult time recognizing the condition or seeking help, doctors and nurses have found that the initial phone call looking for help often comes from a concerned family member or loved one. Recently, the American Academy of Neurology has recommended that doctors evaluate all Parkinson's patients for depression. In addition, in an article in the journal Neurology, scientists said that doctors need to evaluate Parkinson's patients for both apathy and depression. Anyone interested in learning more about the study should call the research coordinator at 415/476-9276. Related Links: UCSF Parkinson's Disease Clinic and Research Center