Does safinamide improve mood in patients with Parkinson’s disease?

In this work, the authors evaluated the effectiveness of safinamide (Xadago) on mood in patients with Parkinson's disease (PD). The study showed that safinamide improved PD patients' mood and emotional wellbeing at 6 months.

Parkinson's disease (PD) is the second most common neurodegenerative disorder. In PD, part of the brain is progressively damaged over many years. The main cause is the loss of nerve cells in a part of the brain called "substantia nigra", which leads to a reduction in a molecule involved in body's movement (called dopamine). Therefore, common PD symptoms include involuntarily shaking of particular parts of the body (tremor), slow movements, and stiff and inflexible muscles. PD patients can also experience depression and anxiety, balance problems, sleep, and memory problems.

The treatment of mood disorder in PD is challenging, due to a poor response to drugs and to the risk of severe side effects when combining PD and mood medications. Safinamide is a drug used to treat movements problems, such as walking, speaking, general difficulty in movements. It is particularly used when other PD drugs (like levodopa) stop working. Recent works also suggested that safinamide might improve depression in PD. 

This study included 50 patients with PD, of which 44 completed the study. Patients received initially 50 mg of safinamide once daily. In some cases, the dose was increased to 100 mg. The patients also completed a questionnaire that evaluates their quality of life. It scored how often people with PD experience difficulties in several areas of daily living (such as attention, memory, activities of daily living, communication, depression, mobility, relationship). Higher scores indicated more difficulties in the daily living areas. Patients were followed up for 6 months.

After 6 months, patients had an improvement in their mood, including apathy (reduction of 57.9%) and emotional well-being (reduction of 40.6%). 

Side effects were reported in 32% of patients. The most common side effects were nausea and dyskinesia (involuntary movements).

The authors showed that safinamide improved the quality of life and mood of patients with PD.

The study was limited by the low number of patients, the absence of a control group (such as a group of people that were not taking safinamide, to compare it with the group using safinamide), and a short follow-up period. This study was funded by Zambon, the manufacturer of safinamide.