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...
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...omplex as that found within the literature on depression and anxiety in PD. Research has linked cortical Lewy bodies and has shown cholinergic deficiency linked to cognitive impairments (Kandiah et al., 2009). Early diagnosis of dementia in a PD patient is important as effect treatments are available (Dujardin, Dubois, Tison, Durif, Bourdeix, Pere et al., 2010). Successful treatment using cholinesterase inhibitors rivastigmine and less successful with dopamine therapy have been found (Davie, 2008; Leroi, Collins & Marsh, 2006). Dementia with Lewy bodies differs from PD with dementia in that the latter has greater cell loss found in the substantia nigra and the former has greater cortical beta-amyloid deposition. Dementia with Lewy body patients is less responsive to dopamine treatment and it can intensify cognitive confusion and hallucinations (Davie, 2008).