Depression in patients with Parkinson's disease

Abstract

Parkinson's disease (PD) is a disabling neurodegenerative condition commonly complicated by the existence of comorbid depression. The prevalence rates of depression in this patient group have been reported to be as high as 40%. Currently, depression in PD is undertreated; there have been few controlled clinical trials of antidepressants in this patient group. Patients with PD are usually elderly and often administered a range of medication, therefore the choice of antidepressant must be undertaken with care. Tricyclic antidepressants (TCAs) have been studied in patients with PD and comorbid depression; however, the risk of anticholinergic side-effects means that their use is largely avoided. Selective serotonin reuptake inhibitors have comparable efficacy to the TCAs and a better tolerability profile in patients with depression; they are rapidly being considered as first-line therapy for PD patients with depression. Clinical studies in this patient group are warranted. This article reviews the characteristics of comorbid depression in patients with PD and discusses the treatment options available.

Depression in Parkinson's disease is related to a genetic polymorphism of the cannabinoid receptor gene (CNR1)

“…In our study, in agreement with other works, depression in PD is more frequent than in the general population, 4,5,47,48 supporting the idea that depression is a genuine part of the PD syndrome. 49 In our study, the severity of depression in PD was similar to other reports.…”

The accuracy of diagnosis of major depression in patients with Parkinson's disease: a comparative study among the UPDRS, the geriatric depression scale and the Beck depression inventory

“…We found a 24% prevalence of major depression in a group of 50 consecutive patients with pd attending a specialized outpatient clinic that is very similar to what was observed by studies assessing similar samples 1,14,15 . The routine clinical evaluation using the updrs showed moderate power to detect depression in pd (sEN of 75% and spE of 63%), considering that the clinicians were not specifically instructed to search for this clinical problem.…”

Nocturnal Disturbances in Patients with Parkinson’s Disease

“…Upon detailed evaluation of nocturnal symptoms, early morning tremor and nocturnal dystonia were closely associated with depressive symptoms. This result is in line with the finding that depressive symptoms were exacerbated during periods of time in which patients experienced nocturnal wearing offrelated (hypodopaminergic state) motor symptoms (Cummings, 1992). While depression can trigger motor fluctuations, such as the wearing off phenomenon (Lieberman, 2006).…”