The use of vortioxetine for the correction of depression in Parkinson's disease: An example of clinical cases

Abstract

The prevalence of depression in Parkinson's disease (PD) amounts to as much as 90%. The paper describes patients at different ages and with different durations of PD in its early and advanced stages and with various types of depressive disorder. The described clinical cases show that depression substantially worsens quality of life in a patient with PD and makes it difficult to choose antiparkinsonian therapy. Depression remains unrecognized on average in half of patients, while only a quarter of patients with identified depression receive timely treatment with antidepressants. PD complicated by depression is characterized by a faster progression and more significantly impaired quality of life and cognitive status than PD without affective disorders. Patients with PD and depressive disorder are characterized by an insufficient response to standard doses of antiparkinsonian drugs, which often leads to an irrational increase in the dose of dopaminergic drugs and to the development of complications. Difficulties in choosing an antidepressant for PD are associated with the development of a complex multicomponent neurotransmitter imbalance in this disease. The prescription of multimodal antidepressants can solve this problem. It is necessary to timely detect and correct depression in patients with PD using the currently available drugs and nonpharmacological methods (psychotherapy and physical rehabilitation).