DOI: https://doi.org/10.22141/2224-0713.7.109.2019.183012

Anxiety and depressive disorder in Parkinson’s disease

A.V. Demchenko

Abstract


The article deals with the modern ideas on pathogenesis, early diagnosis and combined treatment of anxiety and depressive disorders in Parkinson’s disease (PD). Today the researches differentiate two forms of depressive disorders in PD depending on the presence or absence of interrelation with symptoms fluctuation — depression with “of” episodes and depression without “off” episodes. To cure depression, there are used the selective serotonin reuptake inhibitors (SSRI), namely sertraline, paroxetine, citalopram, mianserin, tricyclic antidepressants (TA) — amitriptyline, nortriptyline, imipramine, desipramine, selective serotonin and noradrenaline reuptake inhibitors, particularly reboxetine, presynaptic α2-adrenergic receptor antagonist mirtazapine. The publications present conflicting data on the effectiveness of various antidepressants. SSRI and TA are considered the basic agents for the treatment of depression in PD. A multidisciplinary approach to optimize treatment and caregiving after the patients with PD may include physical and occupational therapy, speech therapy and psychological correction. Psychotherapeutic techniques based on bioadaptive control are increasingly used in neurological practice that is a perspective direction in modern medicine and is called biological feedback. Early diagnosis of non-motor disorders in PD, namely psychoemotional impairment to their timely correction to improve the quality of life of patients with PD and their relatives is of great importance. The further researches are needed to assess the clinical effectiveness of antidepressants for the treatment of anxiety and depressive disorders in PD patients and to optimize the therapeutic combined strategy using non-drug techniques, such as cognitive and behavioural therapy and the method of bioadaptive control.

Keywords


Parkinson’s disease; anxiety and depressive disorders; selective serotonin reuptake inhibitors; tricyclic antidepressants

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