Response to Nortriptyline and Paroxetine Linked to Level of Neuropsychological Impairment in Patients With Parkinson's Disease: Presented at ANA

The use of nortriptyline and paroxetine in the treatment of depression does not affect cognitive functioning in patients with Parkinson's disease (PD); however, the higher the baseline performance on measures of executive functioning, speed of processing, and verbal memory, the better the response to antidepressant treatment, according to results presented here at the American Neurological Association (ANA) 134th Annual Meeting.

"This is one of the few studies to examine the impact of antidepressant treatment on cognition in PD patients with depression," said Roseanne D. Dobkin, PhD, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, New Jersey.

More than 1 million people are affected by PD in the United States alone. It is the second most common neurodegenerative disease in the country, said Dr. Dobkin on October 10.

"Depression is one of the most common nonmotor symptoms of PD, affecting as many as half of these patients," she added.

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Older antidepressant spurs more suicidal thinking in men than newer medication

The largest clinical trial to date comparing an older, tricyclic antidepressant with a newer antidepressant of the selective serotonin reuptake inhibitor (SSRI) class has found that the emergence of suicidal thinking was almost 10 times more common in men taking the older drug than in those taking the newer medication.

The study also found that for men and women taking either medication, suicidal thinking was spread over the first six weeks of treatment, but peaked at roughly the fifth week before declining significantly after week six. Taking place at academic medical institutions across Europe, the trial, called Genome-Based Therapeutic Drugs for Depression--or GENDEP--gauged the responses to antidepressants of 811 persons ranging from 18 to 72 with depression.

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Drug Combo May Offer Best Relief for Nerve Pain

People with nerve pain respond better to a combination treatment using the anticonvulsant gabapentin and antidepressant nortriptyline than to treatment with either drug alone, according to Canadian researchers.

The study findings suggest that combination treatment could be used to help people who only partially respond to one drug or the other.

Nerve, or neuropathic, pain -- which affects 2 to 3 percent of the population -- is "initiated or caused by a primary lesion or dysfunction in the nervous system," according to a news release from The Lancet, which is publishing the study online Sept. 29. Conditions that cause neuropathic pain include nerve problems in the spine, diabetes-related nerve damage and postherpetic neuralgia (PHN), which is nerve pain caused by the varicella zoster virus that can follow an outbreak of shingles.

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