The use of an antagonist 5-HT2A/C for depression and motor function in Parkinson's disease

Abstract

Objective: To test the ability of a 5HT2a/c (trazodone) antagonist, to improve depression and motor function in Parkinson's disease (PD). Method: Twenty PD patients with and without depression were randomly assigned to receive trazodone (group 1) or not (group 2). They were evaluated through UPDRS and Hamilton Depression Rating Scale (HAM-D). Results: For the UPDRS the mean score of group 2 was 33.1±19.7 and 37.1±18.0 at the end. For the group 1, the corresponding scores were 31.4±11.3 and 25.9±13.7. The variations in the Mann-Whitney test were 0.734 at the initial moment and 0.208 at the final moment. The variation in the comparison of the initial moment with the final moment was 0.005 providing statistical significance. For the HAM-D, the mean score went up 4 points in group 2, contrary to a 5.5 points decrease in group 1. Conclusion: Data analysis shows that this agent significantly improves depression, but the motor function improved only in the depressed patients. Because of the known anti-dopaminergic property of the 5-HT2c receptors, a possible approach for depression in PD could be the use of 5-HT2c antagonists, similarly to the use of atypical neuroleptics in case of psychotic symptoms.