A new study shows that antidepressant drugs which only affect serotonin, often used as first choice treatments, may not be best for depression in people with Parkinsona s disease.



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(From Topix Neurology)

This makes no sense to me. WHY test only the older tricyclic which has bad side effects and not the newer AD's with fewer side effects but which affect both serotonin and norepinephrine.

We've discussed those newer drugs here, and people have been helped by them, and quickly, too.

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"Menza also says that in addition to the older antidepressant, nortriptyline, that was tested in the study, there are newer mediations that affect both serotonin and norepinephrinem, and these need to be tested.

Tricyclic antidepressants are one of the older classes of antidepressants and have been used since the 1950s. Tricyclics have an increased risk of overdose and death due to toxic effects on the heart and brain.

“People on a tricyclic antidepressant should have their dosages monitored closely by their doctor,” said Menza.

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I take an old tricyclic, doxepin, mainly for muscle and joint pain, and itching. It also helps one sleep better. I take small doses throughout the day for the itching.

http://www.newswise.com/articles/view/547238/?sc=rsmn

I take Cymbalta. I think it inhibits both serotonin and norepinephrine reuptake.

The happy pill of choice for me is Celexa 10 mg.

John

I will attest to this being true. I now am on nortriptyline and feel better than I have in years. Too bad I had to go to such extents to find this out!

I would recommend to anyone have increased difficulty or that "just can't find the right med" with depression to try nortriptyline.

To add to the post above by NewsBot.

Excerpts:
"Are Older Antidepressants Better For Depression In Parkinson's Disease?
ScienceDaily (Dec. 29, 2008) — A new study shows that antidepressant drugs which only affect serotonin, often used as first choice treatments, may not be best for depression in people with Parkinson's disease. The new research is published in the December 17, 2008, online issue of Neurology®, the medical journal of the American Academy of Neurology. Depression affects up to 50 percent of people with Parkinson's disease.

"In the study, scientists gave 52 people diagnosed with Parkinson's disease and depression either nortriptyline, a tricyclic antidepressant (TCA), paroxetine CR, a selective serotonin reuptake inhibitor (SSRI) or a placebo pill. Tricyclics affect both norepinephrine and serotonin, two different receptors in the brain. The people were tested for improvement of depression symptoms at two, four and eight weeks after starting treatment.

"The study found that the people who took nortriptyline were nearly five times more likely to see improvement in depression symptoms when compared with the people who took paroxetine CR."