Levodopa Improves Psychiatric Symptoms of Parkinson's Disease More Than Dopamine Agonists (P04.195)

OBJECTIVE: To investigate the effects of introducing L-dopa and dopamine agonists on psychiatric symptoms in Parkinson9s disease (PD). 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: 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 Parkinson9s 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: 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 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. Disclosure: Dr. Mcallister has nothing to disclose. Dr. Gruber-Baldini has nothing to disclose. Dr. Anderson has received personal compensation for activities with Boehringer Ingelheim R11 as a consultant and expert medical exaluation. Dr. Anderson has received personal compensation in an editorial capacity as Section editor for Current Treatment Options in Neurology. Dr. Reich has received royalty payments from Informa Publishers. Dr. Reich has received research support from NINDS, Chiltern, Synosia, and Phytopharm. Dr. Fishman has received personal compensation for activities with Pfizer Inc, Forest Laboratories, Inc., Ortho-McNeil Pharmaceuticals, Inc., GlaxoSmithKline, Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Novartis, and Allergan, Inc., as a speaker. Dr. Fishman has received personal compensation in an editorial capacity for Neura. Dr. Weiner has received personal compensation for activities with Santhera and Rexahn. Dr. Weiner has received personal compensation in an editorial capacity for Neurological Reviews and Current Treatment Options in Neurology. Dr. Weiner has received research support from Teva Neuroscience, Boehringer-Ingelheim and Merck Serono. Dr. Shulman has received personal compensation for serving as Editor of the AAN Neurology Now patient book series. Dr. Shulman has received research support from the NIH, Fox Foundation and Teva Pharmaceuticals.