P.1.042 Efficacy and tolerability of depressioninthe treatment of major depression due to Parkinson disease

Weiser, Roberto; Hernandez-Rojas, J.; Gallardo, María José; García, Manuel Lozano; Grau, Mercè Viladrich i; Flores, Juan

doi:10.1016/s0924-977x(04)80131-7

Cited by 3 publications

(5 citation statements)

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“…The most frequently used antidepressants were specific serotonin reuptake inhibitors (SSRIs, 12 trials)22 23 25 28–34 37 38 40 and tricyclics (five trials) 24 32 34 39 41. One trial each used reboxetine,27 atomoxetine35 and mirtazapine 36…”

Section: Resultsmentioning

confidence: 99%

Antidepressants for the treatment of depression in neurological disorders: a systematic review and meta-analysis of randomised controlled trials

Price

Rayner

Okon-Rocha

et al. 2011

Journal of Neurology, Neurosurgery & Psychiatry

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Section: Resultsmentioning

confidence: 99%

Antidepressants for the treatment of depression in neurological disorders: a systematic review and meta-analysis of randomised controlled trials

Price

Rayner

Okon-Rocha

et al. 2011

Journal of Neurology, Neurosurgery & Psychiatry

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“…A small trial of mirtazapine, a presynaptic alpha-2 adrenoreceptor antagonist that increases norepinephrine and serotonin levels, reported as an abstract only, improved depression in PD patients [110]. Success with bupropion has been described in case reports only [111].…”

Section: Pharmacologic Management Of Depressionmentioning

confidence: 99%

Treatment of Cognitive, Psychiatric, and Affective Disorders Associated with Parkinson's Disease

Connolly

Fox

2014

Neurotherapeutics

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Neuropsychiatric symptoms are common in Parkinson's disease (PD) and add significantly to the burden of disease. These symptoms are most commonly part of the disease spectrum owing to pathological changes within relevant brain regions. Neuropsychiatric problems include disorders of cognition, ranging from mild cognitive impairment to dementia, psychotic symptoms, including, most commonly, well-formed visual hallucinations and paranoid delusions, and mood disorders, such as depression and anxiety. The other common cause of neuropsychiatric problem is secondary to use of dopaminergic drugs. Some PD patients may develop behavioral disorders, including impulse control disorders (ICDs) and addictive symptoms. Psychosis can be due to a mixture of underlying pathology, with triggering or worsening of symptoms with changes to PD medications. Currently, management of these disorders primarily uses therapies developed for general psychiatry and cognitive neurology, rather than specifically for PD. However, significant adverse effects, such as worsening of the motor symptoms of PD, can limit use of some drug therapies. Identification of drug-induced symptoms, such as ICDs, enables withdrawal of the offending drug as the principal management strategy. Research is ongoing in an effort to develop more specific therapies for PD-related neuropsychiatric symptoms.

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“…In addition to SSRIs and TCAs, several other antidepressants are available including bupropion, desvenlafaxine, duloxetine, milnacipran, mirtazapine, moclobemide, nefazodone, reboxetine, selegiline, trazodone, venlafaxine, and vilazodone. Of these agents, duloxetine, mirtazapine, moclobemide, nefazodone, and venlafaxine have been evaluated in controlled trials for the management of depression in PD …”

Section: Treatmentmentioning

confidence: 99%

“…Mirtazapine is a dual‐action antidepressant that augments noradrenergic and serotonergic transmission via antagonism of central α 2 ‐autoreceptors and also has antihistaminic properties. In a randomized double‐blind, placebo‐controlled study involving 20 depressed PD patients, mirtazapine 30 mg/day in combination with brief psychotherapy was superior to placebo in reducing depression . Some evidence also suggests that mirtazapine may also benefit tremor and levodopa‐induced dyskinesias .…”

Section: Treatmentmentioning

confidence: 99%

“…The efficacy and safety of various antidepressants in the management of depression in patients with PD has been addressed in numerous uncontrolled and controlled studies . A systematic review and meta‐analysis of 10 studies demonstrated uncertainty and a lack of strong randomized evidence supporting the clinical benefit of selective serotonin reuptake inhibitors (SSRIs) for depression in PD .…”

Section: Treatmentmentioning

confidence: 99%

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Depression in Parkinson's Disease: Identification and Management

Chen

Marsh

2013

Pharmacotherapy

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Depression is a common psychiatric comorbidity in Parkinson's disease (PD) and contributes to significant impairments in cognitive, functional, motor, and social performance. This results in reduced quality of life, higher levels of care dependency, and increased caregiver burden. When treating depression, it is important to ensure that the patient's response to treatment will be adequately monitored. This can be accomplished in neurology or primary care settings, or in clinical settings with interdisciplinary treatment teams. Mental health services should be engaged early as a component of ongoing comprehensive care. This article reviews a general approach to treating the pharmacotherapy of depression in PD. Ultimately, clinicians should rely on empiric assessments of known risks and putative benefits to guide treatment decisions and should include a targeted and individualized multimodal approach that utilizes psychotherapeutic interventions along with pharmacologic therapies.

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P.1.042 Efficacy and tolerability of depressioninthe treatment of major depression due to Parkinson disease

Cited by 3 publications

References 0 publications

Antidepressants for the treatment of depression in neurological disorders: a systematic review and meta-analysis of randomised controlled trials

Antidepressants for the treatment of depression in neurological disorders: a systematic review and meta-analysis of randomised controlled trials

Treatment of Cognitive, Psychiatric, and Affective Disorders Associated with Parkinson's Disease

Depression in Parkinson's Disease: Identification and Management

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