Paroxetine treatment improves motor symptoms in patients with multiple system atrophy.
OBJECTIVE
In view of the putative role of serotonergic neurotransmission in basal ganglia circuitry we investigated the effects of paroxetine (PXT) as a selective serotonin reuptake inhibitor (SSRI) on the motor performance in n=19 patients clinically diagnosed as MSA using a double-blind placebo-controlled randomized study design. In addition, we assessed the effects on the psychopathological status of the patients.


RESULTS
The short-term add-on treatment with PXT up to 30 mg tid for two weeks resulted in a significant improvement of the motor abilities of the upper limbs and speech when compared to placebo. The treatment with PXT was generally well tolerated. The degree of depressive symptoms was not significantly influenced by PXT or placebo during the observation period.


CONCLUSIONS
Previous observations suggest that serotonergic projections may modulate the neuronal excitability of the mesolimbic system and cerebellar system. The observed effects of PXT on motor performance may therefore be due to a direct action of the drug on the motor system. However, these results should be regarded as preliminary, and further research is suggested to evaluate the long-term outcome and clinical relevance of SSRI co-medication in MSA.
Friess
Elisabeth
E
Max Planck Institute of Psychiatry, Kraepelinstr. 10, 80804 Munich, Germany. friess@mpipsykl.mpg.de
Kuempfel
Tania
T
Modell
Sieglinde
S
Winkelmann
Juliane
J
Holsboer
Florian
F
Ising
Marcus
M
Trenkwalder
Claudia
C
D000368:Aged; D001132:Arm; D002531:Cerebellum / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects*; D019578:Multiple System Atrophy / Q000188:drug therapy* / Q000503:physiopathology; D017374:Paroxetine / Q000008:administration & dosage*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D013060:Speech / Q000187:drug effects*; D016896:Treatment Outcome
D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors