KOTA BARU (April 24, 2007): Universiti Sains Malaysia Hospital (HUSM) in Kubang Kerian here has achieved a landmark when it successfully treated a long-suffering Parkinson's disease (PD) patient.
The feat was achieved last March 21 when an electrode implant was placed in the brain of a 54 year-old patient, HUSM consultant neurologist Prof Madya Dr John Tharakan K.J. told a media conference here today.
Retired Telekom Malaysia Berhad employee Che Idris Che Yusoff had been suffering from Parkinson's for 17 years, Bernama reported today.
Tharakan said other than the electrode implant, the surgery which took about three hours also involved placing a battery in the patient's chest.
He added that the patient gave positive reaction during treatment, signalling that HUSM had successfully treated other PD symptoms like essential tremor (ET) and dystonia which caused tremors and stiffness that lead to movement disabilities.
Seven specialists were involved in the surgery where the patient was not injected with anaesthetic except when the battery was placed that took 30 minutes. They included neurosurgeon and neuroscience senior consultant Prof Dr Jafri Malin Abdullah and neurosurgery specialist surgeon Dr Abdul Rahman Izaini Ghani who is also a USM lecturer.
Tharakan said the treatment involved placing a 0.8mm or 10mm wire (electrode) to a sensitive part of the brain and is connected with an electrical wire to a battery placed in the patient's chest.
"
The 1.2mm wire can last a lifetime while the battery has to be changed once every five years at a cost of RM5,000."As soon as the electrode wire was in place and the switch at the battery was activated, the patient started to respond and the hand tremors then stopped," he added.
Tharakan said the Parkinson's surgery at HUSM cost about RM90,000 compared with between RM200,000 and RM250,000 charged by private hospitals.
Updated: 01:55AM Wed, 25 Apr 2007
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Sunday, September 9, 2007
When to have Surgery?
Posted: Wed Aug 29, 2007 5:57 pm Post subject: when to have surgery
--------------------------------------------------------------------------------
I have been researching DBS and reading whatever i can. It seems that there are different thoughts on when to "go for it", In Europe they are doing it much earlier than here. When is it optimum and can there be a time when it is too late to do it?
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Dr. Okun
Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sat Sep 01, 2007 9:06 am Post subject:
--------------------------------------------------------------------------------
All great questions. There are ingoing early intervention studies at Vanderbilt and also in Paris/Kiel. I would advise not going early until there is data to support it---or alternatively doing a clinical trial.
The surgery STN or GPi, works best for medication responsive symptoms. As long as symptoms stay med responsive you are ok. If you want a non-medication (levodopa responsive symptom) then STN or GPi may not be useful (except for dyskinesia and tremor).
The risk is less under the age of 70 and that should factor into your decision.
If you are well controlled on meds I would not rush into surgery.
If you are seeing a specialist and getting to 3 hour or 2 hour intervals then surgery may be reasonable to start talking about.
_________________
Michael S. Okun, M.D.
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Display posts from previous: All Posts1 Day7 Days2 Weeks1 Month3 Months6 Months1 Year Oldest FirstNewest First
--------------------------------------------------------------------------------
I have been researching DBS and reading whatever i can. It seems that there are different thoughts on when to "go for it", In Europe they are doing it much earlier than here. When is it optimum and can there be a time when it is too late to do it?
Back to top
Dr. Okun
Joined: 19 Jan 2007
Posts: 251
Location: University of Florida
Posted: Sat Sep 01, 2007 9:06 am Post subject:
--------------------------------------------------------------------------------
All great questions. There are ingoing early intervention studies at Vanderbilt and also in Paris/Kiel. I would advise not going early until there is data to support it---or alternatively doing a clinical trial.
The surgery STN or GPi, works best for medication responsive symptoms. As long as symptoms stay med responsive you are ok. If you want a non-medication (levodopa responsive symptom) then STN or GPi may not be useful (except for dyskinesia and tremor).
The risk is less under the age of 70 and that should factor into your decision.
If you are well controlled on meds I would not rush into surgery.
If you are seeing a specialist and getting to 3 hour or 2 hour intervals then surgery may be reasonable to start talking about.
_________________
Michael S. Okun, M.D.
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Display posts from previous: All Posts1 Day7 Days2 Weeks1 Month3 Months6 Months1 Year Oldest FirstNewest First
Medication for symptomatic thereapies
Posted: Sun Sep 09, 2007 3:09 pm Post subject: Medication for Symptomatic Therapies
I understand there are now two groups of medications at replacing the dopamine deficiency in the brain of treatment.
There are dopamine agonists and levodopa. As a doctor which are you prefer ? What's effective in treating the symptoms of the disease? Which one are more applicable for younger patient and the older patient or both?
I understand Levodopa is the "wonder-drug" and has been associated with "wearing off" and dyskinesias. The dopamine agonists started at a low dose and increased gradually to avoid side effects that include nausea, vomiting and giddiness on standing.Is it true? What's the reason why some patient start either one agonise and later with both?
I am taking Levodopa i,e. Sinemet 25/100 one dose three times per day and one Jumex 5gm one dose two times per day for 2 years.
Dr. Chew Nee Kong my doctor recently starting me with Requip at low dose and increased gradually to 12 gm with two dose of Sinemet 25/100 to optimize the medication.
My two personnel trainers are surprised that my agility improving by 90% and pleased with my mobility and flexibility. I can do standing tree posture in Yoga. I do not feel tired whilst spending 3 hours gym
classes in the gym centre from Mon to Friday. I do two body massages on every Wed and Saturday to loosen my muscles.
TEOKIMHOE
Back to top
Kathrynne Holden, MS, RD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Sep 08, 2007 4:59 pm Post subject:
--------------------------------------------------------------------------------
Dear Teo,
I am not a doctor, but a registered dietitian; advice regarding medication is outside my scope of practice. I can comment that in general, the agonists are preferred for younger patients, and that some older patients do not do well on them.
I will move your question to "Ask the Doctor." Drs. Okun, Rodriguez, and Fernandez are excellent PD specialists and highly qualified to respond to your concerns.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
Back to top
Dr. Fernandez
Joined: 20 Jan 2007
Posts: 90
Posted: Tue Sep 11, 2007 8:21 pm Post subject:
--------------------------------------------------------------------------------
Deciding which drug to use first in a PD patient is not a one-size-fits-all thing.
In patients who are older or who have more significant symptoms we tend to use sinemet. This is because older patients are less likely to develop motor fluctuations (especially dyskinesias) from sinemet. As for why we use sinemet for more significant symptoms, this is because sinemet is the most efficacious drug there is to date.
In patients who are younger or those who have milder disease, we can start with dopamine agonists such as ropinirole or pramipexole or MAO-inhibitors such as rasagiline. Some may even start with amantadine.
It really all depends on the situation.
Yours,
_________________
Hubert H. Fernandez
Back to top
I understand there are now two groups of medications at replacing the dopamine deficiency in the brain of treatment.
There are dopamine agonists and levodopa. As a doctor which are you prefer ? What's effective in treating the symptoms of the disease? Which one are more applicable for younger patient and the older patient or both?
I understand Levodopa is the "wonder-drug" and has been associated with "wearing off" and dyskinesias. The dopamine agonists started at a low dose and increased gradually to avoid side effects that include nausea, vomiting and giddiness on standing.Is it true? What's the reason why some patient start either one agonise and later with both?
I am taking Levodopa i,e. Sinemet 25/100 one dose three times per day and one Jumex 5gm one dose two times per day for 2 years.
Dr. Chew Nee Kong my doctor recently starting me with Requip at low dose and increased gradually to 12 gm with two dose of Sinemet 25/100 to optimize the medication.
My two personnel trainers are surprised that my agility improving by 90% and pleased with my mobility and flexibility. I can do standing tree posture in Yoga. I do not feel tired whilst spending 3 hours gym
classes in the gym centre from Mon to Friday. I do two body massages on every Wed and Saturday to loosen my muscles.
TEOKIMHOE
Back to top
Kathrynne Holden, MS, RD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Sep 08, 2007 4:59 pm Post subject:
--------------------------------------------------------------------------------
Dear Teo,
I am not a doctor, but a registered dietitian; advice regarding medication is outside my scope of practice. I can comment that in general, the agonists are preferred for younger patients, and that some older patients do not do well on them.
I will move your question to "Ask the Doctor." Drs. Okun, Rodriguez, and Fernandez are excellent PD specialists and highly qualified to respond to your concerns.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
Back to top
Dr. Fernandez
Joined: 20 Jan 2007
Posts: 90
Posted: Tue Sep 11, 2007 8:21 pm Post subject:
--------------------------------------------------------------------------------
Deciding which drug to use first in a PD patient is not a one-size-fits-all thing.
In patients who are older or who have more significant symptoms we tend to use sinemet. This is because older patients are less likely to develop motor fluctuations (especially dyskinesias) from sinemet. As for why we use sinemet for more significant symptoms, this is because sinemet is the most efficacious drug there is to date.
In patients who are younger or those who have milder disease, we can start with dopamine agonists such as ropinirole or pramipexole or MAO-inhibitors such as rasagiline. Some may even start with amantadine.
It really all depends on the situation.
Yours,
_________________
Hubert H. Fernandez
Back to top
The effect of Requip (Ropinirole) medication on me
Posted: Fri Sep 07, 2007 4:53 pm Post subject: Q: Requip
--------------------------------------------------------------------------------
I was diagnosed as Parkinson's disease patient in 2005.
I was prescribed by doctor with Sinemet 25/100 one each three times and Jumex 5 gm one each two times per day for the past of two years.
As my physical agility is not too much improving and I decide to change Dr. NK Chew, Neurologist of Pantai Cheras Medical Centre for treatment on the month of July 07 . He optimises my medication to 4 gm Requip (ropinirole) each three times and one Sinemet 25/100 two times a day. I am surprised my agility is 90% improving as told by my two trainers. I am glad I am able to do stretching exercises and gmx classes ie. body combat, pump, yoga, spinning and box and kick exercises for three hours from Monday to Friday. I do massage on every Saturday to loosen my body tiredness. I rest on bed for an hour after my exercises. I find my Physical mobility and agility is normal and PD is very mild from now as told by Dr. Chew.
I wish to take this forum to express my thanks to Dr. Chew Nee Kong for his excellent work and his contribution for the Parkinson's patients.
TEOKIMHOE
Back to top
Kathrynne Holden, MS, RD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Sep 08, 2007 4:47 pm Post subject:
--------------------------------------------------------------------------------
Dear Teo,
Congratulations, both to you and to your excellent physician, Dr. Chew. He has chosen the best treatment regime for you, and you are working hard to maintain strength and agility to combat PD. You are a fine example for us all.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
Back to top
--------------------------------------------------------------------------------
I was diagnosed as Parkinson's disease patient in 2005.
I was prescribed by doctor with Sinemet 25/100 one each three times and Jumex 5 gm one each two times per day for the past of two years.
As my physical agility is not too much improving and I decide to change Dr. NK Chew, Neurologist of Pantai Cheras Medical Centre for treatment on the month of July 07 . He optimises my medication to 4 gm Requip (ropinirole) each three times and one Sinemet 25/100 two times a day. I am surprised my agility is 90% improving as told by my two trainers. I am glad I am able to do stretching exercises and gmx classes ie. body combat, pump, yoga, spinning and box and kick exercises for three hours from Monday to Friday. I do massage on every Saturday to loosen my body tiredness. I rest on bed for an hour after my exercises. I find my Physical mobility and agility is normal and PD is very mild from now as told by Dr. Chew.
I wish to take this forum to express my thanks to Dr. Chew Nee Kong for his excellent work and his contribution for the Parkinson's patients.
TEOKIMHOE
Back to top
Kathrynne Holden, MS, RD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Sep 08, 2007 4:47 pm Post subject:
--------------------------------------------------------------------------------
Dear Teo,
Congratulations, both to you and to your excellent physician, Dr. Chew. He has chosen the best treatment regime for you, and you are working hard to maintain strength and agility to combat PD. You are a fine example for us all.
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
Back to top
Wednesday, September 5, 2007
Genetic link in Parkinson's ?
Posted: Tue Sep 04, 2007 1:44 pm Post subject: Genetic link in Parkinson's?
--------------------------------------------------------------------------------
Has research shown a genetic link to Parkinson's Disease? My sister told me her toes curl. Does she have a greater risk of developing Parkinson's because I have been diagnosed with it or is that a common symptom?
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Dr. Rodriguez
Joined: 22 Jan 2007
Posts: 92
Location: Gainesville, Fl
Posted: Tue Sep 04, 2007 8:06 pm Post subject:
--------------------------------------------------------------------------------
It is not a common symptom, however, she is at a higher risk, which is very mild, compared with the general population.
Yes, there are some genes already known to be linked with PD, runs in families, and usually start at an early age.
Hope this helps.
_________________
Ramon L Rodriguez, MD
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--------------------------------------------------------------------------------
Has research shown a genetic link to Parkinson's Disease? My sister told me her toes curl. Does she have a greater risk of developing Parkinson's because I have been diagnosed with it or is that a common symptom?
Back to top
Dr. Rodriguez
Joined: 22 Jan 2007
Posts: 92
Location: Gainesville, Fl
Posted: Tue Sep 04, 2007 8:06 pm Post subject:
--------------------------------------------------------------------------------
It is not a common symptom, however, she is at a higher risk, which is very mild, compared with the general population.
Yes, there are some genes already known to be linked with PD, runs in families, and usually start at an early age.
Hope this helps.
_________________
Ramon L Rodriguez, MD
Back to top
Monday, September 3, 2007
Relief for male menopause
Men do get it, after all. Menopause, that is. By the time a man hits 40, he starts to experience a phenomenon similar to the female menopause, called andropause.
But unlike women, men do not have any clear-cut signpost such as the end of menstruation to mark this stage of their life. As a result, most of them find themselves left high and dry - literally.
Hypogonadism - or testosterone deficiency syndrome - is a medical term for when the male sex glands, the testes, produce little or no hormones. It is a condition that usually kicks in during or after middle age and progresses as one grows older.
'Menopause in women is well-established, but few are aware that for men, sex hormone levels do drop off, albeit gradually,' says Michael Wong, medical director of the Singapore Urology and Fertility Centre at Mount Elizabeth Hospital. 'Data shows that after the age of 40, many men begin to lose a percentage of their hormones every year.'
By the time men reach 50, about 8 per cent of them have hormone levels that are below normal. This extends to 15 per cent of all men by age 60. And by 70, almost one in every four men will be affected.
'It is an age-related condition, and given our rapidly greying population, hypogonadism will definitely affect our lives,' says Dr Wong.
According to him, a lot of doctors have difficulty with the issue, primarily because the idea of dropping hormones in males raises a red flag where sex is concerned - a taboo topic in relatively conservative Singapore.
'Unfortunately, there is a negative connotation attached to hypogonadism,' says Dr Wong. 'Actually, there really is a lot more science to it than mere hocus pocus, and education on this is much needed.'
It doesn't help that in the past decade or so, treatment for hypogonadism had been less than satisfactory, with gels, patches or fortnightly injections that provide temporary relief at best.
Worse still, the condition was previously been confused with another male disorder, erectile dysfunction, or ED in short.
'Pre-Viagra days, ED was blamed solely on low hormones, so a lot of people were given extra hormones,' says Dr Wong. 'But doctors treating ED later realised that almost 20 per cent of males suffering from ED don't respond well to medication because what they really had wasn't ED, but hypogonadism.'
Thankfully, there is now a new treatment regime for those suffering from testosterone deficiency. Launched in Singapore last week, Nebido is the world's first long-acting testosterone replacement therapy.
Global men's health expert Aksam Yassin, who is a fellow of the European Board of Urology and chairman of the Department of Urology and Andrology at Segeberger Kliniken in Norderstedt-Hamburg, Germany, hails the new treatment as a breakthrough.
'The old delivery systems of hormone therapy were not very reliable because they cause fluctuations in hormonal levels and such inconsistencies often bring undesired side effects like acne,' says Prof Yassin.
Nebido, however, causes no such problems.
'The release for Nebido is much more constant,' he says. 'One injection can last up to three months, compared with the fortnightly injections previously on offer.'
Prof Yassin, who has administered more than 300 injections of Nebido so far, says the optimal length of treatment is six months to a year.
Welcoming the new treatment, Dr Wong says: 'This is a quantum leap, really. If properly administered, Nebido will effectively take care of the embarrassing symptoms without the hormonal highs and lows associated with other forms of therapy.'
Such symptoms may include - apart from the usual complaint of sexual dysfunction - decreased beard and body hair, breast enlargement and muscle loss.
But hypogonadism can cause more than mere embarrassment.
'Lack of hormones can cause more than just loss of sexual function. It can affect the bones, leading to increased risk of fractures and even the onset of type two diabetes and the fatty belly syndrome,' warns Dr Wong.
Explaining the importance of therapy, Prof Yassin says: 'It is like adding oil to a car. When a car gets old, it needs maintenance. So, too, when men lose their hormones, they need refuelling.'
Each Nebido jab costs about $300. To find out if he needs therapy, a man's testosterone level must first be tested - usually through a simple blood test.
As for the mechanics of the injection, Prof Yassin explains: 'It goes into the backside. Each injection contains 1,000 mg of testosterone in castor oil. It is an oily solution, so the injection must be given slowly.'
He adds with a hearty laugh: 'Since it takes about 60 seconds to complete the injection, we usually try to distract the patient by asking about his family, golf games, job, etc.'
Men do get it, after all. Menopause, that is. By the time a man hits 40, he starts to experience a phenomenon similar to the female menopause, called andropause.
But unlike women, men do not have any clear-cut signpost such as the end of menstruation to mark this stage of their life. As a result, most of them find themselves left high and dry - literally.
Hypogonadism - or testosterone deficiency syndrome - is a medical term for when the male sex glands, the testes, produce little or no hormones. It is a condition that usually kicks in during or after middle age and progresses as one grows older.
'Menopause in women is well-established, but few are aware that for men, sex hormone levels do drop off, albeit gradually,' says Michael Wong, medical director of the Singapore Urology and Fertility Centre at Mount Elizabeth Hospital. 'Data shows that after the age of 40, many men begin to lose a percentage of their hormones every year.'
By the time men reach 50, about 8 per cent of them have hormone levels that are below normal. This extends to 15 per cent of all men by age 60. And by 70, almost one in every four men will be affected.
'It is an age-related condition, and given our rapidly greying population, hypogonadism will definitely affect our lives,' says Dr Wong.
According to him, a lot of doctors have difficulty with the issue, primarily because the idea of dropping hormones in males raises a red flag where sex is concerned - a taboo topic in relatively conservative Singapore.
'Unfortunately, there is a negative connotation attached to hypogonadism,' says Dr Wong. 'Actually, there really is a lot more science to it than mere hocus pocus, and education on this is much needed.'
It doesn't help that in the past decade or so, treatment for hypogonadism had been less than satisfactory, with gels, patches or fortnightly injections that provide temporary relief at best.
Worse still, the condition was previously been confused with another male disorder, erectile dysfunction, or ED in short.
'Pre-Viagra days, ED was blamed solely on low hormones, so a lot of people were given extra hormones,' says Dr Wong. 'But doctors treating ED later realised that almost 20 per cent of males suffering from ED don't respond well to medication because what they really had wasn't ED, but hypogonadism.'
Thankfully, there is now a new treatment regime for those suffering from testosterone deficiency. Launched in Singapore last week, Nebido is the world's first long-acting testosterone replacement therapy.
Global men's health expert Aksam Yassin, who is a fellow of the European Board of Urology and chairman of the Department of Urology and Andrology at Segeberger Kliniken in Norderstedt-Hamburg, Germany, hails the new treatment as a breakthrough.
'The old delivery systems of hormone therapy were not very reliable because they cause fluctuations in hormonal levels and such inconsistencies often bring undesired side effects like acne,' says Prof Yassin.
Nebido, however, causes no such problems.
'The release for Nebido is much more constant,' he says. 'One injection can last up to three months, compared with the fortnightly injections previously on offer.'
Prof Yassin, who has administered more than 300 injections of Nebido so far, says the optimal length of treatment is six months to a year.
Welcoming the new treatment, Dr Wong says: 'This is a quantum leap, really. If properly administered, Nebido will effectively take care of the embarrassing symptoms without the hormonal highs and lows associated with other forms of therapy.'
Such symptoms may include - apart from the usual complaint of sexual dysfunction - decreased beard and body hair, breast enlargement and muscle loss.
But hypogonadism can cause more than mere embarrassment.
'Lack of hormones can cause more than just loss of sexual function. It can affect the bones, leading to increased risk of fractures and even the onset of type two diabetes and the fatty belly syndrome,' warns Dr Wong.
Explaining the importance of therapy, Prof Yassin says: 'It is like adding oil to a car. When a car gets old, it needs maintenance. So, too, when men lose their hormones, they need refuelling.'
Each Nebido jab costs about $300. To find out if he needs therapy, a man's testosterone level must first be tested - usually through a simple blood test.
As for the mechanics of the injection, Prof Yassin explains: 'It goes into the backside. Each injection contains 1,000 mg of testosterone in castor oil. It is an oily solution, so the injection must be given slowly.'
He adds with a hearty laugh: 'Since it takes about 60 seconds to complete the injection, we usually try to distract the patient by asking about his family, golf games, job, etc.'
Sunday, September 2, 2007
Depression and PD
NPF Home Help Search Register Log in
News: Depression and PD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Sep 01, 2007 3:46 pm Post subject: News: Depression and PD
--------------------------------------------------------------------------------
Dear Friends, the following may be of interest. Best, Kathrynne
========================================================
Anti-depressants don't solve depression in patients with Parkinson's Disease
http://www.onmedica.net/content.asp?c=40575&t=1
Many patients with Parkinson's Disease continue to experience depressive symptoms despite taking anti-depressants.
This is the finding of the pan-European PRODEST study in 1,016 patients with Parkinson's disease (PD), which was presented at the 11th Congress of the European Federation of Neurological Societies (EFNS) in Brussels this week.
The study confirmed that depressive symptoms associated with PD are not only highly prevalent, but nearly half (44.1%) of patients receiving antidepressant treatment continued to experience depressive symptoms.
"These symptoms have a significant impact on PD patients' quality of life, often equal in impact to that of the traditionally better known motor symptoms of Parkinson's disease. The results suggest that many depressive symptoms are an expression of Parkinson's disease, rather than of a depressive syndrome," said Professor Paolo Barone, Department of Neurological Sciences, University of Napoli-Federico II, Naples, Italy and lead investigator of PRODEST.
"This consideration, if supported by further analysis of the PRODEST study results, might suggest different treatment approaches of depression in PD," he added.
In those 282 patients with a reported medical history of depression, the study results also showed that over half (54.3%) of these patients had a marked score in The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) with 66% receiving anti-depressant treatment, confirming a persistence of depressive symptoms despite treatment.
Data from recent studies with pramipexole, a non-ergot dopamineagonist, have shown a beneficial effect on the depressive and motivational symptoms in PD. Ongoing trials are aimed to confirm these previous findings.
Professor Matthias Lemke, M.D., Professor of Psychiatry and Medical Director at the Rheinische Kliniken, Bonn, Germany, said: "PD-related depressive symptoms can overlap or even be mistaken for motor symptoms. It is therefore important that physicians learn to differentiate these in order to find the optimal treatment for their PD patients. While pramipexole has proven an effective treatment for the motor symptoms of PD, there is now evidence that pramipexole may also improve PD-related depressive symptoms."
PD-related depressive symptoms have also been studied in an ongoing two-year Italian study, known as PRIAMO. Initial findings of the 55 centre study support the evidence that non-motor symptoms (NMS) are highly prevalent with the majority of patients experiencing one or more NMS. Psychiatric symptoms (anxiety and depression) were rated most frequently and with a high impact on patients' quality of life.
"The conclusions from PRIAMO further support the PRODEST study inhighlighting the need to address the often undiagnosed and under-treated aspects of Parkinson's disease which impart a significant burden on PD patients, relative to their disease severity," Professor Barone told the conference.
http://www.onmedica.net/content.asp?c=40575&t=1
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
Back to top
News: Depression and PD
Joined: 22 Jan 2007
Posts: 94
Location: www.nutritionucanlivewith.com
Posted: Sat Sep 01, 2007 3:46 pm Post subject: News: Depression and PD
--------------------------------------------------------------------------------
Dear Friends, the following may be of interest. Best, Kathrynne
========================================================
Anti-depressants don't solve depression in patients with Parkinson's Disease
http://www.onmedica.net/content.asp?c=40575&t=1
Many patients with Parkinson's Disease continue to experience depressive symptoms despite taking anti-depressants.
This is the finding of the pan-European PRODEST study in 1,016 patients with Parkinson's disease (PD), which was presented at the 11th Congress of the European Federation of Neurological Societies (EFNS) in Brussels this week.
The study confirmed that depressive symptoms associated with PD are not only highly prevalent, but nearly half (44.1%) of patients receiving antidepressant treatment continued to experience depressive symptoms.
"These symptoms have a significant impact on PD patients' quality of life, often equal in impact to that of the traditionally better known motor symptoms of Parkinson's disease. The results suggest that many depressive symptoms are an expression of Parkinson's disease, rather than of a depressive syndrome," said Professor Paolo Barone, Department of Neurological Sciences, University of Napoli-Federico II, Naples, Italy and lead investigator of PRODEST.
"This consideration, if supported by further analysis of the PRODEST study results, might suggest different treatment approaches of depression in PD," he added.
In those 282 patients with a reported medical history of depression, the study results also showed that over half (54.3%) of these patients had a marked score in The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) with 66% receiving anti-depressant treatment, confirming a persistence of depressive symptoms despite treatment.
Data from recent studies with pramipexole, a non-ergot dopamineagonist, have shown a beneficial effect on the depressive and motivational symptoms in PD. Ongoing trials are aimed to confirm these previous findings.
Professor Matthias Lemke, M.D., Professor of Psychiatry and Medical Director at the Rheinische Kliniken, Bonn, Germany, said: "PD-related depressive symptoms can overlap or even be mistaken for motor symptoms. It is therefore important that physicians learn to differentiate these in order to find the optimal treatment for their PD patients. While pramipexole has proven an effective treatment for the motor symptoms of PD, there is now evidence that pramipexole may also improve PD-related depressive symptoms."
PD-related depressive symptoms have also been studied in an ongoing two-year Italian study, known as PRIAMO. Initial findings of the 55 centre study support the evidence that non-motor symptoms (NMS) are highly prevalent with the majority of patients experiencing one or more NMS. Psychiatric symptoms (anxiety and depression) were rated most frequently and with a high impact on patients' quality of life.
"The conclusions from PRIAMO further support the PRODEST study inhighlighting the need to address the often undiagnosed and under-treated aspects of Parkinson's disease which impart a significant burden on PD patients, relative to their disease severity," Professor Barone told the conference.
http://www.onmedica.net/content.asp?c=40575&t=1
_________________
Best regards,
Kathrynne Holden, MS, RD
--
For a Parkinson Tip of the Day visit:
http://www.nutritionucanlivewith.com/
Back to top
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