Arquivos de Neuro-Psiquiatria
Print version ISSN 0004-282X
COSTA, Flavio Henrique de Rezende et al. Depression in Parkinson's disease: diagnosis and treatment. Arq. Neuro-Psiquiatr. [online]. 2012, vol.70, n.8, pp. 617-620. ISSN 0004-282X. http://dx.doi.org/10.1590/S0004-282X2012000800011.
The prevalence of non-motor symptoms in Parkinson's disease (PD) is high. Depression varies from 20 to 50% of the PD patients, and is associated with increasing disability. The key characteristics of depression are anhedonia and low mood. The recommended scales for screening purposes are: HAM-D, BDI, HADS, MADRS and GDS. As for measurement of severity: HAM-D, MADRS, BDI and SDS. In cases with mild depression, non-pharmacological intervention is the treatment of choice. In moderate depression, antidepressants are required. The choice of an antidepressant should be based mainly on the comorbidities and unique features of the patient. Evidence for antidepressant effectiveness is seen mostly with amitriptyline and nortriptyline, but one should be cautious in elderly patients. Other antidepressants that can be prescribed are: citalopram, escitalopram, sertraline, bupropion, trazodone, venlafaxine, mirtazapine and duloxetin. The dopaminergic agonist pramipexole is a treatment option.
Keywords : depression; Parkinson disease; non-motor symptoms.