Antidepressant May Slow Parkinson Disease

An antidepressant medication that has been in use for over 50 years may be used to slow Parkinson disease progression, according to new research.

The drug nortriptyline is indicated for the treatment of depression and nerve pain. Professor Tim Collier, lead author of the studiy and a neuroscientist at Michigan State University, commented on the motivation for the study: "Depression is a very frequent condition associated with Parkinson's, so we became interested in whether an antidepressant could modify how the disease progresses” (September 5, 2017. Science Daily).

Dr Collier and his team started by analyzing medical history of individuals with PD who were also on antidepressants to see if their need to go on a standard PD therapy, levodopa, had been delayed. “We found that those on a certain class of antidepressant, called tricyclics, didn't need the levodopa therapy until much later compared to those who weren't on that type of antidepressant medication,” Dr Collier said.
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The teams next step was to test nortriptyline in rats, which confirmed that the drug was able to decrease the amount of abnormal protein in the brain that causes brain nerve cells to die—a hallmark of PD. In an effort to back these findings up, Dr Collier’s team used a test tube model in order to better understand how nortriptyline impacts how these proteins can clump together; they found that adding nortriptyline to the alpha-synuclein proteins prevented the proteins from clumping together (Neurobiology of Disease. 2017;106:191. doi:10.1016/j.nbd.2017.07.007).

Authors said: “The idea that this clustering effect is controlled by how fast or slow a protein reconfigures itself is typically not a standard way of thinking in research on proteins, but our work has been able to show these changes.”

In short, Dr Collier summarized, “What we’ve essentially shown is that an already FDA-approved drug that’s been studied over 50 years and is relatively well tolerated could be a much simpler approach to treating the disease itself, not just the symptoms.”—Amanda Del Signore