Abstract Details

Title Levodopa Improves Psychiatric Symptoms of Parkinson's Disease More Than Dopamine Agonists

Topic Movement Disorders

Presentation(s) P04 - (-)

Poster/Presentation
Number 195

Objective

Background BACKGROUND: Depression and anxiety are common in PD and associated with worse quality of life (QoL). The effects of dopaminergic medications on psychiatric symptoms are poorly understood.

Design/Methods DESIGN/METHODS: The sample comprised 428 PD patients starting either L-dopa or a dopamine agonist. The Brief Symptom Inventory-18 (BSI-18; depression, anxiety, somatization, and global psychiatric index (GSI) subscales), health-related QoL (SF-12) and Unified Parkinson's Disease Rating Scale (UPDRS) were administered at two consecutive visits, pre- and post-medication initiation. Ratings were compared from baseline (pre) to post-drug initiation using paired t-tests. Changes were compared between medication groups using unpaired t-tests.

Results RESULTS: Patients initiating agonists were younger (59.8 vs. 65.9Y), less impaired on motor UPDRS (24.2 vs 26.8), and more frequently taking antidepressants/anxiolytics (24% vs. 13%) than L-dopa initiators. Baseline levels of depression and anxiety were comparable. Following L-dopa introduction (n=262) there was improvement in BSI-depression (-1.7, p=.03), anxiety (-2.7, p<.01), somatization (-1.8, p=.03), and GSI (-2.6, p<.001). Following agonist introduction (n=166) there was improvement in depression (-2.3, p=.01), but not in anxiety, somatization, or GSI. SF-12 Mental Health QoL scores improved in agonist initiators (+2.0, p=.04), but not in L-dopa initiators. Introduction of L-dopa resulted in greater improvement than agonists in anxiety (p=.02), motor UPDRS (p<.05), and Physical Health QoL (p=.002).

Conclusions CONCLUSIONS: A longitudinal comparison of the effects of introducing L-dopa versus agonists shows that L-dopa results in greater benefits in psychiatric and motor symptoms. L-dopa may be useful in the treatment of psychiatric symptoms in PD.

Authors/Disclosures
Mark Mcallister, MD PRESENTER	No disclosure on file
Ann Gruber-Baldini	No disclosure on file
Karen Anderson	No disclosure on file
Stephen G. Reich, MD, FAAN (Univ of MD Hospital/Dept of Neuro)	Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Best Doctors. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UpToDate. Dr. Reich has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. Dr. Reich has received publishing royalties from a publication relating to health care. Dr. Reich has received publishing royalties from a publication relating to health care.
Paul S. Fishman, MD, PhD (Univ of Maryland Sch of Med)	No disclosure on file
William J. Weiner, MD	No disclosure on file
Lisa M. Shulman, MD, FAAN (University of Maryland School of Medicine)	The institution of Dr. Shulman has received research support from NIH. Dr. Shulman has received publishing royalties from a publication relating to health care. Dr. Shulman has received publishing royalties from a publication relating to health care.
Frank Bennett, PhD	No disclosure on file

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