Treatment of Depression in Patients with Multiple System Atrophy

Depression is a recognised non-motor feature of multiple system atrophy (MSA). Addressing it requires a targeted pharmacological approach that takes the underlying neurodegenerative disease into account.

Multiple system atrophy can present with depression and mood lability alongside its core motor and autonomic features. These psychiatric manifestations increase patient burden and represent a specific clinical situation with dedicated treatment considerations.

The first-line approach centres on a serotonin-targeting antidepressant class that has been evaluated specifically in this patient population — the full protocol identifies the preferred agents and guides their use in practice.

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References

Other symptoms of multiple system atrophy include depression and mood lability (pseudobulbar symptoms).

Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are the drugs of choice for managing depression in patients with multiple system atrophy, and fluoxetine improved emotional and social quality of life in a double-blind, parallel-group, placebo-controlled, randomized trial in patients with probable multiple system atrophy.

DOI: 10.1212/cont.0000000000001598

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