Effects of Venlafaxine on Neuropsychiatric and Motor Symptoms in Patients with Progressive Supranuclear Palsy

Objective: This prospective, ongoing, interventional trial is related to the ProPSP registry and aims to characterize the effects of venlafaxine, a serotonin-norepinephrine reuptake inhibitor, on neuropsychiatric and motor symptoms in patients with progressive supranuclear palsy (PSP).

Background: PSP patients show early degeneration of noradrenergic cells in the locus coeruleus (LC), which correlates with disease severity [1]. The pharmacological approach of substituting the noradrenergic deficit might therefore improve LC related symptoms in PSP [1].

Method: 7 PSP patients were assessed before treatment and after a daily intake of venlafaxine over 4-6 weeks. Characteristics of patients and healthy matched control persons are summarized in table 1 [table1].
At both visits, a disease-specific interview and examination were performed. These comprehend the PSP Rating Scale, the Luria sequence and the three-clap test. Cognitive tests (MoCA, Trail Making Test (TMT), verbal fluency) and questionnaires (Geriatric Depression Scale (GDS), Starkstein Apathy Scale (SAS), PSP-QoL scale, Munich dysphagia test) were performed. Baseline and follow-up scores were compared by ANOVA and post-hoc tests.

Results: Interim mean values of clinical scores and questionnaires at baseline and follow-up are summarized in table 2 [table2]. At follow-up visit, the patients’ overall rating of quality of life, GDS and SAS scores and the time needed for the TMT-B were improved.

Conclusion: These preliminary results indicate that venlafaxine might improve executive functions and features of depression in treated PSP patients.