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Serotonergic antidepressant drugs and L‐dopa‐induced dyskinesias in Parkinson's disease
Author(s) -
Mazzucchi S.,
Frosini D.,
Ripoli A.,
Nicoletti V.,
Linsalata G.,
Bonuccelli U.,
Ceravolo R.
Publication year - 2015
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12314
Subject(s) - serotonergic , dyskinesia , antidepressant , parkinson's disease , medicine , levodopa , dopaminergic , reuptake inhibitor , anesthesia , psychology , serotonin , disease , dopamine , receptor , hippocampus
Background Serotonergic system is believed to play a role in levodopa‐induced‐dyskinesias pathogenesis, and serotonin transporter has been evaluated as potential target. Aim of the study To retrospectively investigate the potential effect of selective serotonin reuptake inhibitors ( SSRI s) during dopaminergic treatment, in the development of dyskinesias in patients with Parkinson's disease ( PD ). Methods One hundred and thirty‐five consecutive patients with PD , with 10‐year follow‐up since diagnosis. Age at PD onset, duration of levodopa treatment, maximum daily dose, and SSRI s exposure were collected. Risk, latency, and severity of dyskinesias were evaluated comparing patients with and without SSRI s exposure. Results Forty‐nine patients received SSRI s for a variable period, 86 were never treated; no significant difference between the groups was observed ( P = 0.897) in the prevalence of dyskinesias. Considering latency between PD diagnosis and dyskinesias onset, patients exposed to SSRI s developed dyskinesias later (6.48 ± 1.99 vs 5.70 ± 1.89 years, P = 0.020). The median dyskinesia severity score was 0 in the exposed group vs 1 in non‐exposed patients ( P = 0.025). Multivariate analysis demonstrated SSRI s exposure as the only independent predictor, protecting from severe dyskinesia. Conclusions Use of SSRI s in patients with PD did not protect from dyskinesias; however, exposure may delay the onset and reduce the severity, confirming modulation of the serotonergic system as possible antidyskinetic strategy.