Treatment of depression in Parkinson’s disease

摘要: Parkinson’s disease (PD) is mainly characterized by its motor problems, although this disease is frequently associated with cognitive and psychiatric morbidity. Depression is the most common psychiatric complication of PD. The mean frequency of depression associated with PD is 43% (range 4-70%). Pharmacotherapy with antidepressant drugs is a most reliable treatment of depression in PD. Antidepressant medications used in patients with PD include tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), monoamino oxidase inhibitors (MAOIs) and newer antidepressants, but only TCAs have been carefully studied (doubleblind, placebo-controlled study) for their antidepressant effects in PD. Electroconvulsive therapy (ECT) is also a treatment modality available for the theraphy of depression in PD with parallel and transient improvement in motor signs, as well. Recent studies suggests the therapeutic potential of transcranial magnetic stimulation (TMS) in depression associated with PD. Double-blind prospective clinical trials are needed to evaluate the safety and efficacy of antidepressants and their effect on motor signs in the tratmen of depression in PD.