Major depression in Parkinson's disease and the mood response to intravenous
methylphenidate: possible role of the "hedonic" dopamine synapse
by
Cantello R, Aguggia M, Gilli M, Delsedime M,
Chiardo Cutin I, Riccio A,
Mutani R
Department of Neurology,
University School of Medicine,
Turin, Italy.
J Neurol Neurosurg Psychiatry 1989 Jun; 52(6):724-31
ABSTRACT
The euphoric response to equivalent doses of intravenous methylphenidate
(MTP) was assessed in a group of 13 Parkinsonian patients affected by major
depression, in a group of 11 nondepressed Parkinsonians, in a group of 14
nonparkinsonian subjects suffering from major depression, and finally in a group
of 12 controls with no CNS or psychiatric disease. Subjects of all four groups
were matched for age, sex and other main characteristics. Depressed and
nondepressed Parkinsonians were also matched for duration and severity of
illness, and for the type of antiparkinsonian treatment. The response to MTP was
evaluated in the context of a double-blind, placebo-controlled study.
Parkinsonian patients with major depression exhibited a significant lack of
sensitivity to the euphoriant effects of MTP, in comparison with the other three
groups. Euphoria produced by central stimulants has been shown to depend on the
activity of a dopamine synapse in humans, which is thought to be situated at the
limbic terminals of dopamine neurons located in the ventral tegmental area.
Degeneration of this system may have predisposed our Parkinsonian patients to
major depression.
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