Since the late 1990s, physicians have noted that dopamine agonists seem to alleviate depression in some people living with Parkinson's. One dopamine agonist manufacturer has tested this theory and found that Mirapex (pramipexole), may improve Parkinson's disease-related depression. While this is helpful information, one study will not sway the medical community to unanimously accept Mirapex as the ideal treatment for Parkinson's-related depression. Other dopamine agonists may be effective depression treatments as well. There is disagreement in the medical community over the best antidepressants, agonists or otherwise, for people with Parkinson's disease. The medical community is still figuring it out and it often tackles depression on a case-by-case basis.
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Boehringer Ingelheim, the maker of Mirapex, sponsored a large study of depression in Parkinson's disease called Profile of Depressive Symptoms in Parkinson's Disease, abbreviated PRODEST. In this study, researchers from a number of institutions across Europe have been following 1,016 patients with Parkinson`s disease. The study participants were evenly divided between early and advanced PD.
Last month at the 11th Congress of the European Federation of Neurological Societies in Brussels, Belgium, the PRODEST researchers reported on their preliminary findings, revealing unique features of PD-related depression and its treatment. The study confirmed that depressive symptoms associated with PD are not only highly prevalent but also nearly half of patients receiving antidepressant treatment continued to experience them.
"These symptoms have a significant impact on PD patients' quality of life, often equal in impact to that of the traditionally better known motor symptoms of Parkinson's disease, commented Professor Paolo Barone, Department of Neurological Sciences, University of Napoli-Federico II, Naples, Italy, and lead investigator of PRODEST in a news release. "The results suggest that many depressive symptoms are expression of Parkinson's disease, rather than of a depressive syndrome. This consideration, if supported by further analysis of the PRODEST study results, might suggest different treatment approaches of depression in PD."
With such a large proportion of the Parkinson's disease patient population unable to achieve satisfactory relief from depression, there is still a lot for physicians and patients to learn about how to address it. Parkinson's-related dopamine, serotonin, and norepinephrine imbalances may not respond to traditional depression medications that have been tested in the general population.
If you live with depression, your physician is your greatest ally. Experimenting with a few different medications over time may help you find some relief from depression and a dopamine agonist may be one of the medications that proves helpful.
