More Than 80 Percent of People With Parkinson's Disease Experience Symptoms of Depression, but Nearly Half are not Discussing Them With Their Doctor
Amsterdam (ots)
- New Pan-European Sociological Survey Announced by the European
Parkinson's Disease Association (EPDA), Reveals the 'Hidden
Face' of PDOver 80 percent of surveyed people with Parkinson's disease (PD) 'often' or 'sometimes' suffer from depressive symptoms as part of their condition, a pan-European survey(1) has revealed today. In some cases, these mood symptoms can impact patients' quality of life as much as the traditionally known 'motor symptoms' of the condition, such as tremor. Despite this, there seems to be a barrier between patients and their doctors when it comes to discussing depressive symptoms during consultations.
The results from the pan-European survey, involving 500 people with mild-to-moderate PD and 500 specialist physicians from five European countries (France, Germany, Italy, Spain, and the United Kingdom) were announced today in collaboration with the European Parkinson's Disease Association (EPDA).
"This survey has confirmed what we've been hearing from people living with Parkinson's disease and the people who care for them, for some time", commented Mary Baker, President of the EPDA. "In many cases, it's not the symptoms that one normally associates with PD that cause the most distress. When your mood is affected, it can be very difficult to maintain a normal outlook on life. Those who are caring for people with Parkinson's disease often report that seeing the person they are caring for feeling depressed is one of the hardest aspects of the condition to deal with."
There is considerable evidence that depressive symptoms in PD are an intrinsic part of the condition, rather than occurring as a result of it. In fact, mood symptoms can often precede development of motor symptoms such as tremor, muscle rigidity and slowness of movement.(2)
The survey has revealed that, although doctors do acknowledge the likely presence of depressive symptoms in their PD patients, they can often find them difficult to recognise. Across Europe, 97 percent of specialist physicians believe that the majority of their PD patients 'often' or 'sometimes' experience depressive symptoms, but 49 percent believe these types of symptoms are difficult to recognise. This is perhaps related to another finding of the survey - that patients are not always reporting these symptoms to their doctor. Around 40 percent of the PD patients who admitted to experiencing depressive symptoms in the survey, said that they 'only occasionally', 'rarely' or 'never' discussed them with their doctor.
When doctors were asked the reasons for not discussing depressive symptoms, the primary reason given was that they felt the patient did not perceive these symptoms as being as important as other aspects of the condition. However, when asked to rate the impact of depressive symptoms on quality and enjoyment of life, both patients and doctors rated them as being almost as impactful as the motor symptoms of PD.
"What we're seeing here is a disconnect between the patients and their doctors, when it comes to addressing this important aspect of the condition. Research has been indicating for some time that mood symptoms are highly prevalent and impactful in Parkinson's disease, but when it comes down to individual doctor/patient relationships, it seems that these symptoms are not always being discussed or addressed on a regular basis", commented Professor Olivier Rascol of Clinical Pharmacology, Toulouse University, France.
Treatment options for depressive symptoms in PD
Results of a new clinical trial, published recently in the Journal of Neurology, have suggested that dopamine agonists, such as pramipexole, could have an anti-depressive effect in PD. Pramipexole is already the most widely used dopamine agonist for the treatment of the motor symptoms of PD, but recent clinical trials have also indicated that it could help improve PD-related mood symptoms, thus indicating that dopamine agonists may be an alternative to antidepressants in PD.(3,4,5)
"We wanted to confirm whether pramipexole could improve mood symptoms independently of its effect on motor symptoms," explained Professor Paolo Barone of Univerita Federico II di Napoli, Napoli, Italy. "In this trial, we therefore only included PD patients who were not currently being troubled by their motor symptoms, but who were experiencing symptoms of depression. We compared the effects of pramipexole to those of sertraline, an SSRI(x), and found that both drugs brought about significant improvements in patients' mood."
Although there is still more research to be done, these early results indicate that there may be hope on the horizon for people with PD, and their carers, who are affected by the depressive symptoms of this condition. Research in this area is ongoing.
Notes to Editors:
The 'Hidden Face of Parkinson's Disease' survey was sponsored by an educational grant from Boehringer Ingelheim.
(x) SSRI - Selective Serotonin Reuptake Inhibitor
References
1. 'Hidden Face of Parkinson's Disease' survey was conducted by Harris Interactive, worldwide market research and consulting firm, January - February 2006.
2. Marsh et al. Neuropsychiatric Aspects of Parkinson's Disease. Psychosomatics 2004; 41 (1): 15-23
3. Barone et al. Pramipexole versus sertraline in the treatment of depression in Parkinson's disease. Neurol 2006 (early on-line publication)
4. Moeller JC, Oertel WH, Koester J, Pezzoli G, Provinciali L Long-term efficacy and safety of pramipexole in advanced Parkinson's disease: results from a European multicenter trial. Mov Disord 20 (5) , 602-610 (2005)
5. Rektorova I, Rektor I, Bares M, Dostal V, Ehler E, Fanfrdlova Z, Fiedler J, Klajblova H, Kulistak P, Ressner P, Svatova J, Urbanek K, Veliskova J Pramipexole and pergolide in the treatment of depression in Parkinson's disease: a national multicentre prospective randomized study. Eur J Neurol 10 , 399-406 (2003)
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