New treatment of depression in Parkinson's disease

Anhedonia and apathy are the main symptoms of depression generally associated with Parkinson's disease. Tricyclic antidepressants (TCA) and selective serotonin reuptake inhibitors (SSRI) have been used to treat depression associated with Parkinson's disease. However, the poor tolerance of TCA and the worsening of the motor function by SSRI have favoured other therapeutic approaches. Some studies have shown that agents stimulating the noradrenergic system were able to improve depression in parkinsonian patients. The serotonin and noradrenaline reuptake inhibitor, milnacipran, has become available recently in Japan. The aim of this study was to investigate the potential of milnacipran to alleviate depressive symptoms in patients suffering from Parkinson's disease, particularly the symptoms anhedonia and apathy.