The pharmacologic management of depression in Parkinson's disease

Abstract

Depression in Parkinson's disease (PD) is common, and it appears to worsen the motor and cognitive progression of the disease, and limits the patient's quality of life. In this paper, we review the pharmacotherapy of depression in people with PD. We find that evidence is sparse when it comes to this patient population. There is some evidence that older tricyclic antidepressants (nortriptyline and desipramine) may be effective in this population. There is also growing evidence that newer antidepressants like paroxetine and venlafaxine may be effective. We will also review a number of other promising medication treatments. What is apparent is the need for more research identifying the most effective medications for treating depression in this population. We provide recommendations that fall in line with current evidence-based practice for managing depression in the general population. Also, we suggest that collaborative models of depression care may be a promising approach to support the identification and effective treatment of those with PD also suffering from depressive disorders.

Antidepressant-Like Properties of Intrastriatal Botulinum Neurotoxin-A Injection in a Unilateral 6-OHDA Rat Model of Parkinson’s Disease

“…Other studies demonstrated that some antiparkinsonian drugs such as dopamine receptor agonists and MAO-B inhibitors like selegiline and rasagiline, when administered in the recommended dose range for the treatment of PD, exerted limited antidepressant efficacy in patients with PD [ 52 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 ]. Also, mirtazapine, atomoxetine, and—interestingly—bupropion, a norepinephrine-dopamine reuptake inhibitor antidepressant, are reported as not effective in treating depression in PD patients [ 82 , 85 , 90 , 91 , 92 ].…”