L. Moretti, G. Perugi - Vol. 6, Settembre 2000, num.3
Testo Immagini
Bibliografia Summary Riassunto
Indice
Depressione e disturbi d'ansia nella
malattia di Parkinson. Implicazioni cliniche e terapeutiche
Depression and anxiety disorders in Parkinson's disease. Clinical and therapeutic
implications
Depression and anxiety disorders, such as social phobia (SPh), panic disorder
(PD), generalized anxiety disorder (GAD), are often associated with Parkinson's
disease. In many cases, depression and anxiety are an important source of sufferance
for the patient and require specific treatment. To date, there are no sufficient
data to indicate the best treatment for anxiety and mood disorders associated
with Parkinson's disease; it is suggested that the patient should be treated
as elderly nonparkinsonian patients. Thus, it is appropriate to choose initially
safe drugs with low incidence of side effects. At this regard, SSRIs are to
be preferred to tricyclic antidepressants, due to their wide spectrum of efficacy
and their good tolerability profile. SSRIs may be associated with antiparkinsonian
medication on a stable basis and in our experience, paroxetine, citalopram and
sertraline are those with the greatest effectiveness and best safety profile.
Since a small proportion of patients receiving SSRIs (less than 5% of all treated
patients) develop such symptoms, in these cases, it is appropriate to discontinue
the drug and shift to another category of antidepressants. Among tricyclic antidepressants,
compounds with less anticholinergic potential should be preferred, such as nortriptyline
or desipramine.
