Depression und Parkinson-krankheit

Abstract

Depression affects approximately 45% of all patients with Parkinson's disease, reduces quality of live independent of motor symptoms and seems to be underrated and undertreated. Depression may manifest as a first symptom of Parkinson's disease many years before motor deficits. Serotonergic, noradrenergic and dopaminergic mechanisms play key roles in the etiology of depression in Parkinson's disease. Tricyclic and newer, selective antidepressants including serotonin and noradrenaline reuptake inhibitors (SSRI, SNRI) in combination with psychoeducation are effective in treating depression in Parkinson's disease, However, selective reuptake inhibitors seem to have a more favorable side effect profile. Recent studies indicate efficacy of new dopamine agonists ropinirole and in particular pramipexole on depressive symptoms in addition to effects on motor deficits in Parkinson's disease.