Fluvoxamine for the treatment of depression and parkinsonism in progressive supranuclear palsy

Progressive supranuclear palsy (PSP) is a parkinsonian-like disorder characterized by postural instability, rigidity, bradykinesia, supranuclear ocular palsy, dysarthria, dysphagia and dementia. There is no satisfactory treatment. A 68-year-old woman with initial progressive supranuclear palsy is described, who was generally apathetic, withdrawn, lacked spontaneity in speech and behavior, and suffered episodes of depression. Treatment with levodopa/carbidopa was ineffective in controlling her parkinsonism and depression, but these symptoms responded to fluvoxamine. This response may be related to fluvoxamine's putative effect on the serotonin system.