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Neuroscience and Behavioral Physiology, Vol. 37, No. 4, 2007
Coaxil (Tianeptine) in the Treatment of Depression in Parkinsons Disease
O. S. Levin
Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 106, No. 3, pp. 2025, March, 2006. Original article submitted December 16, 2005.
An open, non-comparative clinical study was performed to assess the efficacy and safety of tianeptine (Coaxil) in Parkinsons 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: Parkinsons disease, tianeptine, depression.
Depression is one of the most common mental disorders in Parkinsons disease (PD). The tendency to low mood and melancholy was reported in some of his patients by Parkinson himself [38]. Other data [6, 43, 44, 46] show that depression is found in 490% of patients with PD, the average incidence being 4050%. However, depressive symptomatology in most of these patients is mild or moderate, only 422% of patients having more profound depression [15, 43, 45].
The diagnosis of depression in patients with PD is complex because the symptoms are difficult to detect on the background of the other symptoms (hypomimesis, movement retardation, sleep disorders, rapid tiring, decreased body weight, bradyphrenia) [42]. Common signs of depression in PD...