Objective: Patients suffering from Parkinson’s disease experience various motor and non-motor symptoms. Within the range of non-motor symptoms depression is reported as high as in 89% of the Parkinson’s disease patients [1]. Thus, treatment options for depressive symptoms in Parkinson’s disease are of high importance. Here the objective was to observe besides the motoric improvement the effect of safinamide on depressive symptoms.Patients suffering from Parkinson’s disease experience various motor and non-motor symptoms. Within the range of non-motor symptoms depression is reported as high as in 89% of the Parkinson’s disease patients [1]. Thus, treatment options for depressive symptoms in Parkinson’s disease are of high importance. Here the objective was to observe besides the motoric improvement the effect of safinamide on depressive symptoms.
Background: Safinamide acts on motor symptoms and non-motor symptoms of Parkinson’s disease patients, such as pain, depression and emotional wellbeing [2][3]. The latter effect is attributed to the anti-glutamatergic effect of safinamide. A role of glutamate in depression has been reported before, the NMDA-receptor antagonist ketamine showed a positive effect on depressive symptoms [4][5]. Safinamide blocks voltage-gated Na+ channels and thus most probably inhibits the presynaptic release of glutamate, reducing L-Dopa induced glutamatergic hyperacitiviy in Parkinson’s disease patients [6].
Method: The effect of safinamide was retrospectively observed in four Parkinson’s disease patients who showed depressive symptoms before adding safinamide to their Levodopa treatment. The BDI scores and the H & Y scale were determined before starting treatment with safinamide and after treatment with safinamide.
Results: In all three patients the add-on therapy with the MAO-B inihibitor and glutamate modulator safinamide had a positive effect on the H & Y stage and the BDI scores. Therefore, the patients reported an overall improvement concerning the motor ability and their mood and emotional wellbeing.
Conclusion: These results support the post-hoc analyses concerning the positive effect of safinamide on depressive symptoms. Safinamide might thus be considered a valuable Levodopa add-on therapy for Parkinson’s disease patients showing depressive symptoms. However, further studies should be considered to analyze this in more detail.
References: [1] Mindham, R.H. J. Neurol. Neurosurg. Psychiatry (1970), 33:188-191 [2] Cattaneo et al., Adv Ther (2018) 35:515-522 [3] Cattaneo et al., Journal of Parkinson’s Disease (2017), 7:629-634 [4] Machado-Vieira et al., Neuroscientist (2009), 15:525-539 [5] Zarate et al., Harv Rev Psychiatry (2010), 18:293-303 [6] Guerra et al., Brain Stimulation (2019), 12:1517-1525
To cite this abstract in AMA style:
W.E Hofmann. Effect of the MAO-B inhibitor and glutamate modulator safinamide on depressive symptoms in three Parkinson’s disease patients [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/effect-of-the-mao-b-inhibitor-and-glutamate-modulator-safinamide-on-depressive-symptoms-in-three-parkinsons-disease-patients/. Accessed November 24, 2024.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-the-mao-b-inhibitor-and-glutamate-modulator-safinamide-on-depressive-symptoms-in-three-parkinsons-disease-patients/