Some neuron-circuits, provide link of frontal cortex and basal ganglia. Basal ganglia involved in movement, attention, and memory processes. Knowing this, could clarify why disorders of the basal ganglia, are characterised by abnormalities of above mentioned processes (Ring & Serra-Mestres 2002). Parkinson’s disease (PD) is a degenerative disorder of basal ganglia function, which characterised by progressive destruction of the nigrostriatal pathway, thus ensuing decrease in striatal concentrations of neurotransmitter called dopamine (Porth et al 2005). Clinical manifestation of PD includes:
• Fluctuations in motor functions;
• Sleep problems (Porth 2005).
As well as mentioned above symptoms, this condition has major neuropsychiatric co-morbidities for instance: depression, anxiety and some psychotic symptoms. This usually has negative impact on the quality of life of the sufferer and close family (caregivers). Roughly 64 % of PD clients show symptoms of depression (Riedel 2008). Evidence suggest, that PD affected clients with depression incline to experience reduced levels of self-blame and guilt, but increased levels of anxiety, irritability, cognitive deficits, and suicidal ideation, compared to population affected by depression only (Starkstein et al 2008).
The high rate of co-morbidity lead author to investigate possibility of antidepressants treatment, but latest evidence suggests that, pharmacological interaction between PD drugs and antidepressants potentially leads to worsening of Parkinsonism (Jose 2007). As selective serotonin reuptake inhibitors (SSRI) preferred choice of antidepressants in PD, it is worth considering psychotherapeutic management of depressi...
... middle of paper ...
...matic review and meta-analysis of randomized controlled trials. BMC Neurolology 10:49. Electronic. Accessed at: http://link.springer.com/article/10.1186%2F1471-2377-10-49#page-1 01/03/2014
Starkstein SE, Merello M, Jorge R, et al A validation study of depressive syndromes in Parkinson's disease. Mov Disord 2008; 23:538-546
Leaflet. AFT Pharmaceuticals Ltd (2013) AFT Pharmaceuticals Ltd PO Box 33-203 Takapuna Auckland 1309 NEW ZEALAND. Electronic. Accessed at: http://www.medsafe.govt.nz/profs/datasheet/p/Paroxetinemesylatetab.pdf 01/03/2014
Madhusoodanan S., Alexeenko L., Sanders R. & Brenner R. (2010) Extrapyramidal symptoms associated with antidepressants – a review of the literature and an analysis of spontaneous reports. Annals of Clinical Psychiatry 22:3, 148-156. Electronic. Accessed at: https://www.aacp.com/pdf%2F0810%2F0810ACP_Madhusoodanan.pdf 01/03/2014
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