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Serotonergic dysfunction in depression associated with Parkinson's disease

Clinical Neuroscience Research Unit, Ribicoff Research Facilities, Connecticut Mental Health Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Drs. McCance-Katz and Price)
Department of Neurology, Movement Disorders Center, National Parkinson Foundation Laboratory for Clinical and Therapeutic Service, Yale University School of Medicine, New Haven, CT (Dr. Marek).

A 55-year-old man presented with a 5-year history of Parkinson's disease and a 6-month history of major depression. The patient's depressive symptoms responded to treatment with fluvoxamine, a selective and potent serotonin reuptake inhibitor. Tryptophan depletion testing, which acutely lowers central serotonin levels, caused a brief exacerbation of the depressive illness, which resolved upon tryptophan repletion. Serotonergic dysfunction may be an etiologic factor in depression that occurs in Parkinson's disease.

Supported in part by United States Public Health Service grants MH- 14276, MH-30929, and MH-36229, The Lederer Institute Investigator Award, NARSAD, Parkinson's Disease Foundation, and the National Parkinson Foundation.

Address correspondence and reprint requests to Dr. Elinore F. McCance- Katz, Yale University School of Medicine, Department of Psychiatry, 34 Park Street, New Haven, CT 06508.

Received October 22, 1991. Accepted for publication in final form February 21, 1992.

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