Pill

[Teafor22]

Hi. Anybody take antidepressants. Does it help

Thank you

Dot

[silvestrov]

The 2 best antidepressants for PD are amitriptyline and bupropion.

Amitriptyline

michaeljfox.org/foundation/...

movementdisorders.org/MDS/R...

Bupropion/Wellbutrin

asm.confex.com/ipa/11congre...

[Hikoi in reply to silvestrov]

Silvestrov

Do you have an opinion/information on nortriptyline as opposed to amitriptyline. Is one any better than the other?

[silvestrov in reply to Hikoi]

Both amitriptyline and its active component, nortriptyline, have been shown to be good for alleviating depression in PD.

Nortriptyline study (in which it outperformed Paxil):

ncbi.nlm.nih.gov/m/pubmed/1...

In the following article the authors state nortriptyline is better tolerated than amitriptyline:

"Subsequently, the active metabolites of each of these, desipramine and nortriptyline, were marketed and found to be somewhat better tolerated than their parent compounds."

- Amitriptyline has serotonin & noepinephrine reuptake inhibitory action - it prevents the transportation of these neurotransmitters so their levels can build up. Also, amitriptyline has more anticholinergic activity than nortriptyline:

google.com/search?q=nortrip...

Anticholinergic drugs have a long history in PD and have been implicated in the development of dementia so nortriptyline may be the safer of the 2.

health.harvard.edu/blog/com...

As a bonus TCA's like nortriptyline may cautiously be used with MAOi's like Azilect:

Drug therapy reviews: tricyclic antidepressant and monoamine oxidase inhibitor combination therapy.

"The preferred dosage regimen is administration of the MAOI t.i.d. during the day and the entire TCA dose at bedtime."

ncbi.nlm.nih.gov/m/pubmed/3...

Comparatively speaking, bupropion/Welbutrin has norepinephrine & dopamine reuptake activity.

ncbi.nlm.nih.gov/pmc/articl...

When compared to sertraline/Zoloft bupropion:

"Comparison of the changes from base line to end point revealed significantly greater improvement in both depressive as well as motor symptoms of PD with bupropion then with the sertaline on all three efficacy measures."

asm.confex.com/ipa/11congre...

Part of bupropion's effectiveness is its anti-inflammatory action. There are many studies implicating tumor necrosis factor in PD as a source of inflammation and many studies showing bupropion decreasing TNF. The following study shows bupropion lowering the risk of glaucoma by 21% (by lowering TNF):

"There was no significant association between use of tricyclic antidepressants (HR = 1.000, (CI: 0.997-1.004), p = 0.95) or selective serotonin reuptake inhibitors (HR = 0.999, (CI: 0.997-1.001), p = 0.39) and development of OAG."

ncbi.nlm.nih.gov/m/pubmed/2...

Interestingly,

"Amitriptyline and nortriptyline inhibit interleukin-1β and tumour necrosis factor-α release by rat mixed glial and microglial cell cultures"

..yet had no effect on the development of glaucoma.

academic.oup.com/ijnp/artic...

Bupropion cannot be taken with MAOis. Unlike bupropion, neither amitriptyline or nortriptyline improved motor symptoms of PwP.

[Hikoi in reply to silvestrov]

Thankyou Silvestrov

[Cookie1124 in reply to silvestrov]

Do you take both these together? I take Wellbutrin

But I feel like I need something more. Do you find that lwelbutrin causes weight gain?

[silvestrov in reply to Cookie1124]

I am not on any antidepressants and, in regards to weight loss, Wellbutrin/bupropion is used for the binge eating/purging condition known as bulimia:

ncbi.nlm.nih.gov/pubmed/313...

In the article it mentions Wellbutrin causes seizures and it is one of the possible side effects of the drug.

A full listing of bupropion side effects:

drugs.com/pro/wellbutrin.html

Also, there is a sustained release form of bupropion:

medicinenet.com/bupropion_s...

In reading about bupropion I discovered an article which stated in 3 cases of dopamine agonist impulse disorders (ID), Wellbutrin reduced ID symptoms - including binge eating. The following article is a PDF file download and it contains a series of articles including one on a high calorie/low protein diet for PD patients who have dyskinesia and weight loss. The article 'Bupropion abates dopamine agonist-mediated compulsive behaviors in Parkinson\'s disease' is the third or forth article in the file and it notes that the patients on DA lost weight when taking bupropion.

pdflegend.com/queue/bupropi...

Interestingly, a zinc supplement, say zinc picolinate, might be a good supplement to Wellbutrin or SSRI antidepressants.

Evidence of functional zinc deficiency in Parkinson's disease.

ncbi.nlm.nih.gov/pubmed/101...

Antidepressant activity of zinc and magnesium in view of the current hypotheses of antidepressant action.

ncbi.nlm.nih.gov/pubmed/190...

Interaction of bupropion and zinc with neuronal nicotinic acetylcholine receptors.

ncbi.nlm.nih.gov/pubmed/217...

Effects of zinc supplementation in patients with major depression: a randomized clinical trial.

"The results of the present study indicate that zinc supplementation together with SSRIs antidepressant drug improves major depressive disorders more effectively in patients with placebo plus antidepressants (SSRIs)."

ncbi.nlm.nih.gov/pubmed/241...

[rebtar]

Yes, and yes. I would probably not be here were it not for antidepressants. I was afraid to try it, but it made all the difference. Make sure you're evaluated by a psychiatrist in communication with your neurologist, to find what is the most appropriate AD for your situation. Some antidepressants are stimulating, some sedating, and different ones work for different people. A good doctor will assess you and start you on a trial for a few weeks, if you get bad side effects or it doesn't help, he/she will try something else. Hopefully they will hit it right on the first try, that was my experience but it's not always that way. There's now genetic testing to help ID which drugs are more likely to work for you, some doctor's will do this and it's helpful. I had mine done by a company called GeneSight 5 years ago, they did it FOR FREE because my income was less than $130,000 per year (or something like that), otherwise it's expensive.

AD's can take several weeks to start working. It takes patience and trust in your doctor. But if you're depressed and it's been going on for a while, and you can't see your way clear, it's definitely a good option. Therapy and exercise can also help a lot, but that's not always sufficient.

Living with depression is a horrible way to live, and can be life threatening. Do get the help you need.

[Cookie1124 in reply to rebtar]

I used to take Prozac and Abilify and they worked for my Anxiety/depression so well it wasn't even funny. And I needed it. Those of you who experience depression anxiety, it is not something you can just "get over" and you're not feeling sorry for yourself. You are reacting to alarms going off in your body and it feels Horrible! I had to go off the Abilify because of the parkinsons and I haven't felt "right" since then. Am trying Wellbutrin and mirtazipine now.

[luba1]

I take lexapro. It works for me.

[moparkie715]

Venlafaxine - works for me . Anxiety