RETROSPECTIVE STUDY OF DRUG RESPONSE IN 87 PATIENTS WITH PROGRESSIVE SUPRANUCLEAR PALSY

Progressive supranuclear palsy (PSP) is a progressive neurodegenerativ e disease that responds poorly to pharmacologic intervention despite i ts clinical, neurochemical, and pathologic similarity to Parkinson's d isease. We reviewed our experience with drugs used in the treatment of patients with PSP who were followed in the Department of Neurology, U niversity of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. Of 136 patients identified, adequate drug-response dat a were available for 87 (64%). Benefit and adverse effects of therapy were graded on a 4-point scale: 0, none; 1, minimal; 2, moderate; 3, m arked. The three most frequently used drugs were amitriptyline (32% of patients benefited), imipramine (28% of patients benefited) and levod opa/carbidopa (Sinemet) (38% of patients benefited). Levodopa/carbidop a, amantadine, selegiline, and amitriptyline gave the best risk/benefi t ratios. Monotherapy tended to show more benefit and fewer adverse ef fects than polypharmacy.