• Login
    View Item 
    •   DSpace Home
    • Centro Académico de Salud (CAS)
    • Hospital Universitario Austral -HUA-
    • Investigación Aplicada
    • View Item
    •   DSpace Home
    • Centro Académico de Salud (CAS)
    • Hospital Universitario Austral -HUA-
    • Investigación Aplicada
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of DSpaceCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Statistics

    View Usage Statistics

    Combined rasagiline and antidepressant use in Parkinson disease in the ADAGIO study: effects on nonmotor symptoms and tolerability.

    Thumbnail
    View/Open
    IA - Smith (72.29Kb)
    Date
    2015-01-01
    Author
    Smith, Kara.
    Eyal, Eli.
    Weintraub, Daniel.
    Metadata
    Show full item record
    Abstract
    IMPORTANCE: Depression, cognitive impairment, and other nonmotor symptoms (NMSs) are common early in Parkinson disease (PD) and may be in part due to disease-related dopamine deficiency. Many patients with PD are treated with antidepressants for NMSs, and the effect of the combination of PD medications that enhance dopamine neurotransmission and antidepressants on NMSs has not been studied. We report the effects of the addition of a monoamine oxidase B inhibitor, rasagiline, to antidepressant treatment in PD. OBJECTIVE: To evaluate the effect of rasagiline on depression, cognition, and other PD NMSs in patients taking an antidepressant in the Attenuation of Disease Progression With Azilect Given Once Daily (ADAGIO) study. DESIGN, SETTING, AND PARTICIPANTS: The ADAGIO study was a double-blind, placebo-controlled, delayed-start trial of rasagiline in de novo PD. In this exploratory post hoc analysis, we analyzed patients taking an antidepressant during the 36-week phase 1 period, in which patients were randomized to rasagiline (1 or 2 mg/d) or placebo. MAIN OUTCOMES AND MEASURES: We evaluated the change in NMSs in patients taking an antidepressant and rasagiline compared with those taking placebo. The NMSs were assessed by Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale Nonmotor Experiences of Daily Living, the original Unified Parkinson's Disease Rating Scale, and the Parkinson Fatigue Scale. RESULTS: A total of 191 of the 1174 patients (16.3%) were treated with antidepressants during phase 1 and provided efficacy data. Depression and cognition scores revealed significantly less worsening in the rasagiline group compared with the placebo group (differences in Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale item-adjusted means [SEs], -0.19 [0.10], P = .048, and -0.20 [0.05], P < .001, respectively). Parkinson Fatigue Scale (mean [SE] difference, -0.42 [0.09], P < .001) and daytime sleepiness (mean [SE] difference, -0.24 [0.09], P = .006) scores also revealed significantly less worsening in the rasagiline group compared with placebo. There was a nonsignificant trend toward less worsening in apathy and no significant between-group differences in anxiety or sleep. The effect on depression remained significant after controlling for improvement in motor symptoms (mean [SE] difference, -0.23 [0.09], P = .009). There were no serious adverse events in the combined rasagiline-antidepressant group suggestive of serotonin syndrome. CONCLUSIONS AND RELEVANCE: The combination of rasagiline and antidepressants in patients with de novo PD is associated with reduced worsening of a range of NMSs in preliminary analyses. Adverse effects appear uncommon with this combination. These findings suggest a role for dopamine-enhancing therapies in NMSs in early PD and encourage further study and confirmation.
    URI
    https://riu.austral.edu.ar/handle/123456789/835
    Collections
    • Investigación Aplicada

    xmlui.dri2xhtml.structural.info-link
    Licencia Creative Commons
    xmlui.dri2xhtml.structural.contact-link1 - xmlui.dri2xhtml.structural.contact-link2
    xmlui.dri2xhtml.structural.info-link2
     

     


    xmlui.dri2xhtml.structural.info-link
    Licencia Creative Commons
    xmlui.dri2xhtml.structural.contact-link1 - xmlui.dri2xhtml.structural.contact-link2
    xmlui.dri2xhtml.structural.info-link2