Depression in multiple system atrophy: A case report

A 53-year-old woman who developed depression as the first symptom of multip le system atrophy was treated. Depression was followed successively by auto nomic failure, parkinsonism and cerebellar ataxia. Treatment with L-DOPA, L -threo-DOPS, and thyroid releasing hormone was associated with improvement of autonomic failure and parkinsonism. As for depression, scores on the Zun g scale and the Hamilton scale improved from 58 to 49 and from 30 to 22, re spectively. This case is remarkable in that depression preceded neurologic dysfunction and was managed successfully by antiparkinsonian medication. A common underlying disturbance may be responsible for the depression and neu rologic dysfunction in multiple system atrophy.