Among 49 consecutive patients with Parkinson's disease, 40% were
depressed according to DSM-III; they had major depression or dysthymic
disorder accompanied by sleep disturbance, fatigue, psychomotor
retardation, loss of self-esteem, and excessive guilt. During a 10-day
dopamine-free period, lumbar puncture was performed to measure the
metabolites of dopamine, serotonin, and norepinephrine. Patients were given
an overnight dexamethasone suppression test, and the effects of
thyrotropin-releasing hormone and L-dopa on plasma growth hormone and
prolactin were examined. Level of CSF 5-hydroxyindoleacetic acid was lowest
in parkinsonian patients with major depression and was related to
psychomotor retardation and loss of self-esteem.
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