Patients with chronic brain diseases such as Parkinson's disease and epilepsy have an unusually high rate of depression, too -- suggesting links between the conditions, doctors said.

Two reports in the journal Neurology said doctors and patients alike were unaware of the link and that patients often went untreated for their depression.

"Many patients assume that it's normal to feel this way. They might say, 'If you had Parkinson's disease, you'd feel this way too'," said Dr. Irene Richard, a neurologist at the University of Rochester Medical Center in New York.

"That's not true. If you treat the depression, they'll still have the other symptoms of the disease, but they feel better. It's one aspect of the disease that may be very treatable."

It is not simply being disabled that causes the depression, she said.

"People diagnosed with other serious diseases that may also be disabling, such as rheumatoid arthritis, aren't nearly as likely to become depressed," Richard said.

She and colleague Dr. William McDonald found that nearly half of all patients with Parkinson's also have depression and propose that there could be a physical link between the two conditions.

Researchers at Columbia University in New York, for instance, have found a gene known to cause a movement disorder known as dystonia causes a type of early-onset depression.

Parkinson's is also a movement disorder, caused by the destruction of brain cells that produce an important message-carrying chemical called dopamine.

An estimated 1 million people in North America have Parkinson's disease.

A second study found a strong association between depression and epilepsy, which can cause seizures.

Dr. Alan Ettinger of the Long Island Jewish Medical Center found that 36.5 percent of 775 patients with epilepsy had symptoms of depression and 35.8 percent of them had never discussed this with their doctors.

An estimated 2.5 million Americans have epilepsy, while depression is the most common psychiatric disorder, affecting up to 1 in 10 Americans.

"When selecting an anti-epileptic treatment, clinicians should strongly consider using agents that not only will help epilepsy but may also improve symptoms of depression," Ettinger said.

"Better treatment may also help these patients improve their overall quality of life, particularly in work, social and family domains."

Reference Source 89
September 30, 2004

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