[Pain and depression in Parkinson's disease: new therapeutic possibilities of pramipexole].
An aim of a study was to establish the relationship between pain, motor complications and depression in Parkinson's disease and evaluate an effect of the 3 months therapy with the dopamine receptor agonist pramipexole (mirapex). Seventy-eight patients with idiopathic parkinsonism, aged 56-73 years, including 18 patients in stage 1-1,5 of the disease; 31 patients - in stage 2; 20 patients - in stage 3 and 9 patients - in stage 4, were studied. A stable response to the therapy was observed in 28 patients, motor complications in 50. A patient's state was assessed with widely-used scales. Thirty patients were assigned to pramipexole as an add-on therapy to L-DOPA and amantadin. Patients with dementia did not receive pramipexole. Thirty-five patients (44,8%) had pain complaints. This percentage was significantly higher (62%) in patients with motor complications. Multiple regression analysis revealed that pain scores were significantly correlated with motor complication and motor fluctuation scores. Back pain scores were correlated with an extent of posture disturbances. Mild depression and depressed mood were found in 37 patients (47,4%). VAS scores in these patients were significantly higher compared to patients without mood disturbances. The intensity of pain was correlated with depression severity. Patients treated with mirapex reported the reduction of pain by 48,2% (p<0,0001) during the "on-period". During the "off-period", the reduction of pain intensity was less (23,7%) but still significant. Depression scores were decreased to the end of the 12th week of treatment from 15,2+/-2,3 to 10,4+/-3,5 (p<0,0001).
Letvinenko
I V
IV
Odinak
M M
MM
Mogil'naia
V I
VI
D000368:Aged; D000547:Amantadine / Q000627:therapeutic use; D052160:Benzothiazoles / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D010147:Pain Measurement; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology*; D000077487:Pramipexole; D012720:Severity of Illness Index
D052160:Benzothiazoles; D018491:Dopamine Agonists; D000077487:Pramipexole; D000547:Amantadine