Depression in Parkinson's Disease: A Narrative Review

Abstract

Parkinson's disease (PD) is a progressive neurodegenerative age-related disorder that affects the central nervous system (CNS) and is characterized by uncontrollable movements such as shaking, stiffness, and loss of balance and coordination. Depression is a common non-motor manifestation of PD, but unfortunately, depression remains unrecognized and often undertreated. The underlying pathophysiology of depression in PD is complicated, and many studies have been conducted to know the exact cause, but the question remains unanswered.In this article, we discuss various pathophysiologies by which depression occurs in PD. The most widely accepted theories are neuroinflammation and monoamine oxidase theory. This article also explored the pharmacological treatment of depression in PD; this involves standard antidepressant therapy such as tricyclic antidepressants (TCA), serotonin-norepinephrine reuptake inhibitors (SNRI), selective serotonin reuptake inhibitors (SSRI), and monoamine oxidase inhibitors (MAO); non-pharmacological treatments such as electroconvulsive therapy (ECT), cognitive-behavioral therapy (CBT) have also been discussed. However, physicians hesitate to prescribe antidepressants to patients with PD due to concerns about harmful drugdrug interactions between antidepressants and antiparkinsonian drugs. Despite the complicated link between PD and depression, the co-administration of antidepressants and antiparkinsonian drugs is safe and beneficial when appropriately managed. However, early recognition and initiation of treatment of depression in PD reduces the longitudinal course and improves the cross-sectional picture. This review article also explored the clinical and diagnostic findings and impact on the quality of life of depression in PD.

Animal Approaches to Studying Risk Factors for Parkinson’s Disease: A Narrative Review

“…Depression is present in approximately 40 to 60% of patients with PD, and the presence of this symptom worsens the already poor quality of life of individuals with this disease [163][164][165][166][167]. It is important to note that depression, or other mood disorders, can occur prior to the onset of motor symptoms [168], and that early treatment of depression associated with PD can promote better acceptance of the signs of the disease [169,170].…”

Relationship Between Short-chain Fatty Acids and Parkinson’s Disease: A Review from Pathology to Clinic

“…Depression is the most common neuropsychiatric disorder among people with PD and is related to the degeneration of monoaminergic neurotransmitter systems and fronto-cortical dysfunctions [ 135 ]. A case-control study confirmed that low fecal BA content and a decrease in the genera Roseburia , Romboutsia , and Prevotella were related to depressive symptoms in PD patients [ 136 ].…”

Depression in Parkinson’s Disease – Profile and Assessment

“…About the disease-specific risk factors for depression in PD there are scanty data with ambiguity validity. In some studies, was shown that severe disability, earlier age of onset, more on/off fluctuations, family history of PD, are risk factors [20], in other study the brain disturbance is another disk factor [21]. The influence of genetic factors is ambiguous.…”