At Cure Parkinson’s we’ve kept a very close eye on the tricyclics story. In 2016 – after seeing proof that tricyclics had protective effects in parts of the brain affected in Parkinson’s – our International Linked Clinical Trials (iLCT) committee prioritised nortriptyline for further research. Since then, further alpha-synuclein evidence has strengthened the case even further.
Now we’re driving discovery forward, by collaborating with a large clinical trial comparing nortriptyline with escitalopram (an SSRI class of antidepressant) for the treatment of depression in people with Parkinson’s. It’s called the ADepT-PD trial and it begins recruiting participants in 2021.
The trial will involve 400 people with Parkinson’s and depression from all across the UK. Its primary goal is to assess how effective the different medicines are at treating depression in Parkinson’s, and how the side effects compare.
This is a very important trial that could lead to big improvements in the way depression is treated. However, at Cure Parkinson’s we’re searching for ways to slow, halt and reverse Parkinson’s itself. That’s why we’re funding a substudy of the main trial, to investigate the critical question of whether nortriptyline could alter the course of the disease. The substudy will employ wearable technology, as well as standard methods of clinical evaluation, to assess whether a year’s course of nortriptyline has any effect on movement symptoms in people with Parkinson’s.
The results of the sub-study will hopefully be available in 2023. In the meantime, we’ll be strongly advocating for further research into the potential Parkinson’s-modifying effects of tricyclic antidepressants. We’ll also be keeping our ear to the ground for medicines that could have similar potential with fewer side effects, as well as ways that the side effects of tricyclics might be mitigated.