Antidepressants and PD
Medically based treatments are commonly used in treating depression in PD patients. It is suggested that when choosing the correct antidepressant medication, the major symptom should be of focus. For example, if an anxious patient presents with sleep difficulties, a sedative antidepressant should be prescribed. However, it is noted that with the progression of PD, antidepressant should be monitored as some have negative effects with the course of PD (ex. psychomotor retardation in the case of the sedative antidepressant) (Reichmann et al., 2009). Tricyclic antidepressants are commonly used with patients presenting exclusively with major depression, but little research has been done with PD patients and should be used with caution (Reichmann et al., 2009). A Cochrane review conducted in 2003 found only three randomized control trials of 106 depressed patients diagnosed with PD and the researchers concluded that there was limited data to support the effectiveness of antidepressants (Ghazi-Noori, Chung, Deane, Rickards & Clarke, 2003). Further research is warranted on the effects of medications used to treat anti-parkinsonism symptoms in tandem with drugs used to treat depression. The most common antidepressant used with PD is selective serontonic re-uptake inhibitors (SSRI), and interestingly, very little research has been conducted on its use and long term treatment (Reichmann et al., 2009).
Treatment of depression for PD patients
There is a lack of research literature on psychotherapy treatment of depression with PD patients (Veazey, Cook, Stanley, Lai & Kunik, 2009); this may be due to feasibility of long term research with this population as well as sample being unable to come to treatment due to motor challenges. Cognitive behavioural therapy (CBT) is a commonly used treatment modality used with depressed PD patients. Veazey et al. (2009) found CBT administered to PD patients via phone was an excellent treatment program, with a very small sample, the patients showed significant reductions in their overall presenting symptoms. All participants said they had preferred telephone treatment over in-person sessions; however, the therapist had difficulty reading the affect of their patients.
Another common nonmotor symptom seen in patients with PD is anxiety disorders (such as panic, generalized anxiety and phobic disorders; Siri et al., 2010). The prevalence estimates of anxiety within PD patients vary from 3.6% to 40% (Dissanayaka, Sellback, Matheson, O’Sullivan, Silburn, Byrne, et al., 2010). The relationship between anxiety and PD is often confusing as many symptoms of anxiety mimic those found in PD. Similar to depression in PD, it is unclear as to whether anxiety precedes PD, is a risk factor for PD or early manifestation of the disease (Jacob, Gatto, Thompson, Bordelon & Ritz, 2010). In the largest population-based sample of incident PD, Jacob and colleagues (2010) found that...