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. 1998 Oct;6(11):34-46.

Treatment of Depression in the Patient with Parkinson's Disease

Tiffany W Chow  1 , Jeffrey L Cummings  1
Affiliations

Treatment of Depression in the Patient with Parkinson's Disease

Tiffany W Chow et al. Clin Geriatr. 1998 Oct.
No abstract available

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Figures

Figure 1
Figure 1
Algorithmic approach to pharmacological treatment of depression in Parkinson's disease: If depressed and suicidal, treat with ECT; if depressed but not suicidal, reevaluate antiparkinsonism medications. Add selegiline if not already part of antiparkinsonian regimen; if inadequately treated for depression at this point, stop selegiline and begin SSRIs. More studies have focused on proving efficacy of TCAs than SSRIs, but the side-effect profile for SSRIs is more favorable for PD patients. Each antidepressant medication should have a six-week trial at the maximum tolerated therapeutic dosage or at the appropriate plasma level; if inadequately treated for depression with SSRIs, initiate treatment with TCAs; if inadequately treated for depression, consult a specialist in mood disorders, who may use ECT; once adequate antidepressant therapy has been identified, antidepressant medications should be continued for at least six months before tapering of the drug is attempted.
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