title: Depression in multiple system atrophy: a case report.
abstract: A 53-year-old woman who developed depression as the first symptom of multiple system atrophy was treated. Depression was followed successively by autonomic failure, parkinsonism and cerebellar ataxia. Treatment with L-DOPA, L-threo-DOPS, and thyroid releasing hormone was associated with improvement of autonomic failure and parkinsonism. As for depression, scores on the Zung scale and the Hamilton scale improved from 58 to 49 and from 30 to 22, respectively, This case is remarkable in that depression preceded neurologic dysfunction and was managed successfully by antiparkinsonian medication. A common underlying disturbance may be responsible for the depression and neurologic dysfunction in multiple system atrophy.
authors.affiliation: Department of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Goto
authors.forename: A
authors.initials: A
authors.lastname: Ueki
authors.forename: H
authors.initials: H
authors.lastname: Shimode
authors.forename: H
authors.initials: H
authors.lastname: Shinjo
authors.forename: C
authors.initials: C
authors.lastname: Miwa
authors.forename: Y
authors.initials: Y
authors.lastname: Morita
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001921:Brain / Q000098:blood supply* / Q000473:pathology*; D003863:Depression / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D015899:Tomography, Emission-Computed, Single-Photon; D001745:Urinary Bladder Diseases / Q000175:diagnosis* / Q000503:physiopathology; D014563:Urodynamics
chemical_list: D000928:Antidepressive Agents; D000978:Antiparkinson Agents; D007980:Levodopa