Parkinson's Disease Tulip


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Old 12-05-2008, 09:12 AM #1
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Default ADHD drug trial for executive dysfunction in PD

Mov Disord. 2008 Nov 21.
Atomoxetine for the treatment of executive dysfunction in Parkinson's disease: A pilot open-label study.

Marsh L, Biglan K, Gerstenhaber M, Williams JR.

Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Executive dysfunction (ED) is a prominent and often disabling feature of cognitive impairment in Parkinson's disease (PD). Few studies have examined treatments. Given the role of noradrenergic pathology in ED, atomoxetine, a norepinephrine reuptake inhibitor indicated for attention deficit hyperactivity disorder (ADHD), may be a potential treatment for PD-related ED. Twelve patients with PD and disabling ED completed an 8-week pilot open-label, flexible dose (25-100 mg/day) trial of atomoxetine. On primary outcome measures, atomoxetine was associated with improved ED based on the Clinical Global Impression-Change Scale (75% positive response rate; 95% CI: 43-95%, P < 05) and behavioral measures of ED [Frontal Systems Behavior Scale (FrSBE) Executive Dysfunction and Connors Adult ADHD Rating Scale (CAARS) inattention/memory subscales]. Adverse effects included sleep and gastrointestinal disturbances and hypomania. Atomoxetine is tolerable in PD and may benefit clinical manifestations of ED, warranting further study in controlled trials. (c) 2008 Movement Disorder Society.

PMID: 19025777 [PubMed - as supplied by publisher]

http://www.docguide.com/news/content...=19025777&ref=
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Old 12-05-2008, 05:38 PM #2
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Default very interesting

I need to look into this. my executive function is DIS-functioning!

thanks for posting.
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Old 12-05-2008, 11:09 PM #3
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Default Look ma, I'm in the paper!

I was in that very study. I stopped the atomoxetene after the study was over because it was making me grouchy at full dose, although at full dose it was having an effect and was quite tolerable. We have talked a couple of times about using it again at a lower dose, but I haven't had a burning need for it or had other issues that took priority. Strangely, the drug seemed to kick me up a level and I regained some executive function which persists to the present. It's like it reminded me how to jump through that hoop and I still remember how.

Dr. Biglan, by the way, a very pleasant person and a crackerjack neuro/MDS, has left JH to return to the University of Rochester.

Jaye
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"Thanks for this!" says:
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Old 12-06-2008, 01:23 AM #4
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Jaye, do you know of anyone else who has tried Strattera off-label for PD executive dysfunction? You mentioned that it made you grouchy. Was this an aggressive type of grouchy, e.g., impatient with others, or just generally hard to get along with? I assume that the grouchienss did not continue after stopping the drug, even though you seemed to continue with some ED improvement. I could certainly use some help with apathy these days.
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Old 12-06-2008, 09:28 AM #5
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Adverse effects included sleep and gastrointestinal disturbances and hypomania.
I'm sorry, this really slays me. Sleep and gastrointestinal function are absolutely primary issues to effective management of PD. I find medical acceptance, without further comment, of these side effects to be unconscionable.
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Old 12-06-2008, 10:13 AM #6
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Quote:
Originally Posted by RLSmi View Post
Jaye, do you know of anyone else who has tried Strattera off-label for PD executive dysfunction? You mentioned that it made you grouchy. Was this an aggressive type of grouchy, e.g., impatient with others, or just generally hard to get along with? I assume that the grouchienss did not continue after stopping the drug, even though you seemed to continue with some ED improvement. I could certainly use some help with apathy these days.
I tried it, no effect.

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Old 12-07-2008, 06:21 AM #7
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Default effects of atamoxetene

Gee, RL, I think chasmo tried it and it didn't do anything for him (sorry I'm late in answering. Thanks, Charlie). He was already pretty sharp, though.

The grouchiness was more felt than expressed; after all, I'm never hard to get along with (motto: If you can't smile, stay home). I have no idea if the drug is useful for apathy. The drug seemed to me to give me the boost I neeed for executive dysfunction. I wasn't in touch with the other subjects and couldn't possibly evaluate the results objectively.

J.
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