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Depression in PD related to catecholaminergic rather than serotonergic system

1.176 The neuropathological basis for depression in Parkinson's disease

Parkinsonism & Related Disorders, Volume 13, Supplement 2, 2007, Page S53
P. Frisina, V. Haroutunian, L. Libow

Depression is found in 30–40% of all patients with Parkinson's disease (PD), but its etiology is unclear. Using neuropathology as a signpost for neurotransmitter function, we investigated the prevalence of pathological features found at postmortem and sought to uncover differences between depressed (n = 11) and non-depressed (n = 9) elderly PD patients. The results indicate a higher prevalence of pathological features in depressed compared to non-depressed PD patients, particularly in catecholamine areas of the brain; the locus coeruleus (neuronal loss: odds ratio = 7.2, p = 08; gliosis: odds ratio = 18.0, p = 008); dorsal vagus nerve (gliosis: odds ratio = 7.63, p < 0.05), and substantia nigra pars compacta (gliosis: odds ratio = 2.85, ns). However, neuropathological differences were absent in the dorsal raphe nuclei, amygdala, and cortical regions. Our evidence suggests that depression in PD is related more to catecholaminergic than serotonergic system dysfunction.

http://tinyurl.com/bffds2

http://www.sciencedirect.com/science...e588ff4e92c634

I would think this would make a difference in medications to resolve clinical depression. Anyone know about that?

Jaye

Depression in PD related to catecholaminergic rather than serotonergic system

Depression in PD related to catecholaminergic rather than serotonergic system

what does that mean - in english?

serotonergic and catecholaminergic

Serotonin
A chemical produced by the brain that functions as a neurotransmitter. Low serotonin levels are associated with mood disorders, particularly depression. Medications known as selective serotonin reuptake inhibitors (SSRIs--ie Prozac) are used to treat disorders characterized by depressed mood.

Catecholamine: any of a group of sympathomimetic amines (including dopamine, epinephrine, and norepinephrine) which function as neurotransmitters in the brain
The catecholamines play an important role in the body's physiological response to stress ( the "fight or flight" response to perceived severe stress/danger--these neurotransmitters are responsible for the reactions one gets such as increased heart rate, increased respiratory rate, dilated pupils, increased perfusion to muscles, etc.
One of the major catecholamine uptake inhibitors (theoretically helps keep the neurotransmitters around longer, stopping their degradation) is Welbutrin-

Thus, Prozac works on decreasing serotonin degradation, keeping it around longer; Welbutrin works on the catecholamines norepinephrine and dopamine, keeping them around longer....

http://medical-dictionary.thefreedic.../catecholamine

Here's how depression works in people without PD:

Quote:

A combination strategy was something I'd been sharing with medical students and patients for years. It arises from understanding the role of what I call "the three tenors," the three key neurotransmitters in the brain that regulate mood--serotonin, dopamine and norepinephrine. As an opera lover, I like to see them as voices singing in the mind. When they sing in harmony and balance, they can make a person feel comfortable in life. But when one of the tenors is out of sync, the music can be disturbing, even frightening.
It may be ordinary knowledge for a psychiatrist to appreciate how each neurotransmitter works--that serotonin regulates worry and anger, that dopamine is critical for initiative and pleasure and that norepinephrine controls alertness and energy. But this information is rarely shared with those being treated. It should be, because it is often the foundation for a successful treatment, one that manages to work even after many others have failed.

...in the last several years many quiet discoveries have been made in the clinical practice of psychiatry. First, it was discovered that not all antidepressants are effective for severe depressions. Also, that antidepressants with dual action--those that influenced two tenors, like serotonin and norepinephrine--often performed better than the antidepressants that target a solo tenor. And further, that combining antidepressants often worked better than using a single one.

]From "The Three Tenors"
By Alen J. Salerian 
Special to The Washington Post 
Tuesday, June 20, 2000; Page Z09

Now, from the dictionary link at the top of the page:

Quote:

Catecholamines include adrenaline, noradrenaline and dopamine, with roles as hormones and neurotransmitters.

and serotonergic means

Quote:

Related to the action of serotonin or its precursor l-tryptophan.

So those of us who receive serotonergic medications might have tons of serotonin running around our brains, but perhaps insufficient amounts of the other two of the "three tenors," namely dopamine and norepinephrine. I'm no doctor, don't even work in the health field, and when I did it was in Medical Records. So ask your doctor about this.

Jaye

Note: olsen posted a much better reply while I was typing.

one more little question

do endorphins fall into the same tenor/catagory as adreniline? sorry about spelling. I would think that since hormones are linked in there with the feel good stuff that a woman's menstral cycle would call for an increase in targeted medication just before a period to counteract depression. When I was still menstrating my symptoms flaired dramatically then. But back then - there hadn't been much of any studys done and young onset was baffling to doctors. Now there is a lot more about it.

Do you mean "estrogens" and adrenaline? recent research associated the presence of ovaries with a decreased incidence of parkinson's in women, concluding that estrogen must have a protective effect from onset of parkinson's .

http://psychcentral.com/news/2007/08...risk/1215.html
Estrogen Therapy Lowers Parkinson Risk
By Rick Nauert, Ph.D.
Senior News Editor
"...Before age 50, estrogen replacement therapy may, in fact, be beneficial for the brain function of women who have their ovaries removed. This large study involved reviews of medical records and follow-up interviews with approximately 4,600 women.

Prior to this Mayo Clinic report, there was limited or conflicting clinical and epidemiological evidence about estrogen’s ability to protect brain functioning in women, referred to as neuroprotection.

The Mayo research results show that not only did women who had one or both ovaries removed before menopause have an increased risk for Parkinson’s disease or parkinsonism compared to other women, but that the risk increased the younger the woman was at ovary removal..."

You may read about "endorphins" here:
http://en.wikipedia.org/wiki/Endorphin

The endocrine system, of which all these compounds are a part, is an intricate system with many complex feed-back mechanisms--I suspect many women with parkinson's could validate your experience of such variation and intensification of symptoms with their menstral cycle.

re. depression in PD related to catecholaminergic . . . .

THANK YOU OLSEN AND JAYE!!

thank you sooooooooo much for taking the time to explain that stuff!
I really appreciate it and perhaps others reading it were given the
gift of a better understanding.

I think that was very true that the system of chemical checks and
balances is very intertwining, intricate, complex system and that there
is a lot yet to learn about it that we don't know.

but this site helps chip away at it and things are learned here and
shared here in a unique way.

thanks again,

jingle

Effexor works on both seratonin and norepinephrine; I've had success with it.

My pharmacist told me about a new Effexor generic that is in pill rather than capsule form - does anyone know if this has been proven as equally effective?

serotonin vs catecholamine systems for depression

News release of study reinforcing antidepression drugs affecting more than serotonergic system more effective:

http://www.wemove.org/stayconnected/article.asp?ID=1161

WE MOVE News
Subject: The Treatment of Depression in Parkinson Disease: SSRI or TCA?

Article is Copyrighted and can't be posted. Please check out the link to read the article.

I was in Philadelphia on Tues and Weds for a CERE-120 followup and Dr. Stern (my PI) gave me the "lecture of the day" joking that he only lectures once a day and today (Wed) it was my day.

His lecture was about Depression and Exercise, stating that there is more and more research on depression and PD, as well (as we all know) about exercise and quality of life with PD.