Is anhedonia permanent
Pramipexole relieves depression in Parkinson's disease
About 40 to 50 percent of Parkinson's patients have depression, which also affects their quality of life. Common symptoms of depression in Parkinson's patients are hopelessness, a feeling of emotional emptiness, and loss of vitality, which is also known as anhedonia. This is what private lecturer Matthias Lemke from Bonn reported.
Besides dopamine receptors of type D2, pramipexole (Sifrol®) preferentially stimulates the D3 receptors in the limbic system and in the frontal cortex. D3 receptors are important in the pathogenesis of depression and anhedonia, said Lemke at an event organized by Boehringer Ingelheim in Düsseldorf. Among the dopamine agonists, pramipexole has the highest preference for D3 receptors.
The dopamine agonist is the drug of choice for depressed patients with Parkinson's disease because of its effect on motor skills, drive and mood, according to Lemke. Compared to the dopamine agonist pergolide, in an open study with 41 depressed Parkinson's patients after eight months, the severity of the depression was significantly reduced after eight months with 1.9 mg pramipexole daily; with 3 mg pergolide daily, the value on the Montgomery-Asberg depression scale changed However not.
In an observational study, 657 depressed Parkinson’s patients in advanced stages received pramipexole 1 mg daily as the mean dose in addition to L-dopa. During the observation period of 63 days, depression and anhedonia decreased and the dose of L-Dopa could be reduced from an average of 372 mg to 344 mg per day. The proportion of patients with anhedonia fell from 47 to 25 percent and the number of patients who did not have depression rose from 200 to 350 patients.
In a further observational study with a comparable group of patients, 74 percent of 1392 depressed Parkinson's patients indicated that after 45 days of additional therapy with pramipexole, their moderate to severe depression had significantly decreased, according to Lemke.
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