Wednesday, April 14, 2004

What Antidepressants Aren't

This item, from the Annals of Neurology, shows an unexpected property of paroxetine.  Paroxetine is an SSRI antidepressant that is used widely.   I post this because some critics disparage antidepressants, saying that they "just mask your feelings."  In fact, I have had a number of patients tell me that they have more emotional intensity, and awareness, while taking such medications.  Also, I have had psychotherapists who treat these patients tell me that the patients are more emotionally alive when they take such medications.

It is important to note that increased emotional intensity and awareness do not always occur when antidepressants are given.  It is possible for the opposite to occur, although it is uncommon.  When it does occur, it is an unintended adverse effect.  In such cases, it may be desirable -- or even necessary -- to switch to a different kind of medication.  The point here is this: dampening of emotional experience is not necessary for the therapeutic effect to occur.

1: Ann Neurol. 2004 Apr;55(4):590-4.
Paroxetine retards disease onset and progression in Huntingtin mutant mice.

Duan W, Guo Z, Jiang H, Ladenheim B, Xu X, Cadet JL, Mattson MP.

Laboratory of Neurosciences, National Institute on Aging Intramural Research Program.

We report that administration of paroxetine, a widely prescribed antidepressant drug that acts by inhibiting reuptake of the neurotransmitter serotonin, suppresses the neurodegenerative process and increases the survival of huntingtin mutant mice, an animal model of Huntington's disease (HD). Paroxetine attenuated motor dysfunction and body weight loss and improved glucose metabolism in the HD mice. Paroxetine was beneficial when treatment was initiated before or after the onset of motor dysfunction, suggesting a potential for such antidepressant drugs in the treatment of presymptomatic and symptomatic HD patients.

This study shows that antidepressants can have a neuroprotective effect: they can slow down the destruction of nerve cells in some cases.  Of course, this shows the effect in mice.  It would take clinical studies in humans to show that there is any clinical utility to this.