Advertisement

Neuroscience and Behavioral Physiology

, Volume 37, Issue 4, pp 419–424 | Cite as

Coaxil (tianeptine) in the treatment of depression in Parkinson’s disease

  • O. S. Levin
Article

Abstract

An open, non-comparative clinical study was performed to assess the efficacy and safety of tianeptine (Coaxil) in Parkinson’s disease (PD). A total of 18 patients with PD were used whose clinical state increased moderately severe and more profound depression (assessed on the Hamilton and Beck scales). After three months of treatment, depression on the Hamilton depression scale was decreased by 34% and on the Beck scale by 31% compared with baseline data (p < 0.05). Improvements in mental status were noted in 14 of 18 patients (77%); eight patients (44%) showed more than 50% reductions on the Hamilton scale. Analysis of the structure of depressive symptomatology showed that improvement occurred because of decreases in anxiety and the severity of somatoform symptoms and, to a lesser extent, in melancholy and sleep disturbance. There was no significant change in apathy. The decrease in the severity of depression was accompanied by an improvement in the quality of life. The efficacy of Coaxil was greater in patients with less marked depressive and motor symptoms, shorter durations of illness, and less marked cognitive impairments. Coaxil was well tolerated by the patients. The data obtained here provide grounds for recommending the use of Coaxil in the treatment of depression in PD.

Key words

Parkinson’s disease tianeptine depression 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Zh. M. Glozman, V. N. Shtok, N. M. Saltykova, et al., “Clinical psychological investigations of depressive syndrome in Parkinson’s disease,” Vestn. Mosk. Gos. Univ., Series 14, 3, 29–36 (1995).Google Scholar
  2. 2.
    Zh. M. Glozman and O. S. Levin, “Mental impairments in extrapyramidal disorders,” in: Extrapyramidal Disorders [in Russian], V. N. Shtok, I. A. Ivanova-Smolenskaya, and O. S. Levin (eds.), Moscow (2002), pp. 74–86.Google Scholar
  3. 3.
    Zh. M. Glozman, O. S. Levin, and N. Yu. Lycheva, “Impairments of emotional memory and the recognition of emotional states in patients with Parkinson’s disease,” Fiziol. Cheloveka, 6, 55–60 (2003).Google Scholar
  4. 4.
    V. L. Golubev, Ya. I. Levin, and A. M. Vein, Parkinson’s Disease and Parkinsonism Syndrome [in Russian], Moscow (1999).Google Scholar
  5. 5.
    O. S. Levin, “Treatment of early-stage Parkinson’s disease,” in: The World of Medicines [in Russian] (2001), Vol. 1, pp. 41–47.Google Scholar
  6. 6.
    O. S. Levin, “Mental disorders in Parkinson’s disease and their correction,” in: Extrapyramidal Disorders: A Handbook of Diagnosis and Treatment [in Russian], V. N. Shtok, I. A. Ivanova-Smolenskaya, and O. S. Levin (eds.), Medpress-inform, Moscow (2002), pp. 125–152.Google Scholar
  7. 7.
    O. S. Levin, Clinical-Neuropsychological and Neuroimaging Aspects of the Differential Diagnosis of Parkinsonism [in Russian], Author’s abstract of thesis for doctorate in medical sciences, Moscow (2003).Google Scholar
  8. 8.
    O. S. Levin, Difficult Problems in the Treatment of Parkinson’s Disease and Pathways to Their Solution [in Russian], Moscow (2003).Google Scholar
  9. 9.
    O. S. Levin, Zh. M. Glozman, and N. Yu. Lycheva, “The internal picture of illness and the quality of life of patients with Parkinson’s disease,” in: A. R. Luriya and Psychology in the 21st Century [in Russian], T. V. Akhutina and Z. H. Glozman (eds.), Moscow (2003), pp. 114–121.Google Scholar
  10. 10.
    O. S. Levin, I. G. Smolentseva, and B. Tseredsodnom, “The effects of dopaminergic therapy on neuropsychological functions in patients with Parkinson’s disease,” Nevrol. Zh., 3, 31–37 (2004).Google Scholar
  11. 11.
    International Statistical Classification of Diseases and Health-Related Problems [Russian translation], WHO, Geneva (1998), 10th edition, Vol. 1.Google Scholar
  12. 12.
    S. N. Mosolov, Clinical Use of Contemporary Antidepressants [in Russian], MIA, St. Petersburg (2003).Google Scholar
  13. 13.
    I. G. Smolentseva, The Effects of Dopamine Receptor Agonists on Motor and Neuropsychological Disorders in Patients with Parkinson’s Disease [in Russian], Author’s abstract of thesis for doctorate in medical sciences, Moscow (2000).Google Scholar
  14. 14.
    A. B. Smulevich, Depression in Somatic and Mental Diseases [in Russian], MIA, Moscow (2003).Google Scholar
  15. 15.
    V. N. Shtok, O. S. Levin, and N. V. Fedorova, Extrapyramidal Disorders [in Russian], MIA, Moscow (2002).Google Scholar
  16. 16.
    D. Aarsland, J. P. Larsen, N. G. Lim, et al., “Range of neuropsychiatric disturbances in patients with Parkinson’s disease,” J. Neurol., 67, 492–496 (1999).Google Scholar
  17. 17.
    Y. Agid, F. Javoy-Agid, and M. Ruberg, “Biochemistry of neurotransmitters in Parkinson’s disease, ” in: Movement Disorders 2, C. D. Marsden and S. Fahn (eds.), Butterworths, London (1987), pp. 166–230.Google Scholar
  18. 18.
    G. Alexopoulos, “The depression-executive dysfunction syndrome of late life,” Amer. J. Geriatr. Psychiatr., 9, 22–29 (2001).CrossRefGoogle Scholar
  19. 19.
    A. T. Beck, C. H. Ward, M. Mendelson, et al., “An inventory for measuring depression,” Arch. Gen. Psychiatr., 4, 561–571 (1961).PubMedGoogle Scholar
  20. 20.
    H. Braak, K. Del Tredici, H. Bratzke, et al., “Staging of the intracerebral inclusion body pathology associated with idiopathic Parkinson’s disease (preclinical and clinical stages),” J. Neurol., 249, Supplement 3, 1–5 (2002).CrossRefGoogle Scholar
  21. 21.
    R. Brooks, R. Rabin, and F. de Charro, The Measurement and Valuation of Health Status Using EQ-5D, Kluwer Academic Publishers, Dordrecht (2003).Google Scholar
  22. 22.
    D. J. Burn, “Beyond the iron mask: towards better recognition and treatment of depression associated with Parkinson’s disease,” Mov. Dis., 17, 445–454Google Scholar
  23. 23.
    J. L. Cummings, “Depression in Parkinson’s disease,” Amer. J. Psychiat., 149, 443–454 (1992).PubMedGoogle Scholar
  24. 24.
    J. L. Cummings, “Frontal-subcortical circuits and human behavior,” Arch. Neurol., 50, 873–880 (1993).PubMedGoogle Scholar
  25. 25.
    EuroQoL Group, “EuroQoL: a new facility for the measurement of health-related quality of life,” Health Policy, 16, 199–208 (1990).CrossRefGoogle Scholar
  26. 26.
    S. Fahn and R. L. Elton, “Unified rating scale for Parkinson’s disease,” in: Recent Developments in Parkinson’s Disease, S. Fahn and C. D. Marsden (eds.), Macmillan, Florham Park, New York (1987), pp. 153–163.Google Scholar
  27. 27.
    W. Gibb and A. Lees, “The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease,” J. Neurol. Neurosurg. Psychiatr., 51, 745–752 (1988).PubMedCrossRefGoogle Scholar
  28. 28.
    J. D. Guelfi, C. Dulcire, P. Lemoine, et al., “Clinical safety and efficacy of tianeptine in 1858 depressed patients in general practice,” Neuropsychology, 25, 140–148 (1992).Google Scholar
  29. 29.
    M. Hamilton, “A rating scale for depression,” J. Neurol. Neurosurg. Psychiatr., 23, 56–62 (1960).PubMedGoogle Scholar
  30. 30.
    M. Hillen and J. I. Sage, “Nonmotor fluctuations in patients with Parkinson’s disease,” Neurology, 47, 1180–1183 (1996).PubMedGoogle Scholar
  31. 31.
    M. Hoehn and M. D. Jahr, “Parkinsonism: onset, progression and mortality,” Neurology, 17, No. 5, 427–442 (1967).PubMedCrossRefGoogle Scholar
  32. 32.
    T. Klaassen, “Treatment of depression in Parkinson’s disease,” J. Neuropsychiat. Clin. Neurosci., 7, 281–286 (1995).Google Scholar
  33. 33.
    A. F. G. Leentjens, J. Martinus, J. J. van Hilten, et al., “The contribution of somatic symptoms to the diagnosis of depressive disorder in Parkinson’s disease: A discriminant analytic approach,” J. Neuropsychiat. Clin. Neurosci., 15, 74–77 (2003).Google Scholar
  34. 34.
    A. F. G. Leentjens, “Depression in Parkinson’s disease: conceptual issues and clinical challenges, ” J. Geriatr. Psychiatr. Neurol., 17, 120–126 (2004).CrossRefGoogle Scholar
  35. 35.
    O. S. Levin and V. N. Shtock, Disconnection Between Cognitive and Emotional Functions as a Factor of Dementia in Parkinson’s Disease and Subcortical Vascular Encephalopathy, Eurobrain, Aasborg (1997).Google Scholar
  36. 36.
    M. L. Levy, J. L. Cummings, L. A. Fairbanks, et al., “Apathy is not depression,” J. Neuropsychiat. Clin. Neurosci., 10, 314–319 (1998).Google Scholar
  37. 37.
    S. Mattis, Dementia Rating Scale: Professional Manual, Psychological Assessment Resources, Odessa, FL (1988).Google Scholar
  38. 38.
    J. Parkinson, An Essay on the Shaking Palsy, London (1817).Google Scholar
  39. 39.
    G. C. Pluck and R. G. Brown, “Apathy in Parkinson’s disease,” J. Neurol. Neurosurg. Psychiatr., 73, 636–642 (2002).PubMedCrossRefGoogle Scholar
  40. 40.
    I. H. Richard, R. Kurlan, C. Tanner, et al., “Serotonin syndrome and the combined use of deprenyl and an antidepressant in Parkinson’s disease,” Neurology, 48, 1070–1077 (1997).PubMedGoogle Scholar
  41. 41.
    A. Shrag, M. Jahanshahi, and N. Quinn, “What contributes to depression in Parkinson’s disease?” Psychol. Med., 31, 65–73 (2001).CrossRefGoogle Scholar
  42. 42.
    L. M. Shulman, R. L. Taback, and A. A. Rabinstein, “Non-recognition of depression and other non-motor symptoms in Parkinson’s disease,” in: Parkinsonism and Related Disorders (2002).Google Scholar
  43. 43.
    J. R. Slaughter, K. A. Slaughter, D. Nichols, et al., “Prevalence, clinical manifestations, etiology and treatment of depression in Parkinson’s disease,” J. Neuropsychiatr. Clin. Neurosci., 13, 187–196 (2001).Google Scholar
  44. 44.
    S. E. Starkstein, M. L. Berthier, P. L. Bolduc, et al., “Depression in patients with early versus late onset of Parkinson’s disease,” Neurology, 39, 1441–1445 (1989).PubMedGoogle Scholar
  45. 45.
    S. E. Starkstein and M. Merello, Psychiatric and Cognitive Disorders in Parkinson’s Disease, Cambridge University Press (2002).Google Scholar
  46. 46.
    D. Weintraub, P. J. Moberg, J. E. Duda, et al., “Recognition and treatment of depression in Parkinson’s disease,” J. Geriatr. Psychiatr. Neurol., 16, 178–183 (2003).CrossRefGoogle Scholar
  47. 47.
    D. Weintraub, K. H. Morales, P. J. Moberg, et al., “Antidepressant studies in Parkinson’s disease: a review and meta-analysis,” Mov. Dis., 20, 1161–1169 (2005).CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2007

Authors and Affiliations

  • O. S. Levin
    • 1
    • 2
  1. 1.Department of NeurologyRussian Medical Academy of Postgraduate EducationRussia
  2. 2.Center for Extrapyramidal DiseasesFederal Health AgencyMoscow

Personalised recommendations