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Parkinson’s Disease And Depression

Combatting Depression And Parkinsons Disease

Parkinson’s Disease and Depression: Symptoms and Treatments

This 2-page fact sheet distinguishes between sadness and depression, lists 10 signs of depression in PD, explains causes and treatment options of depression for those with PD. Those with PD should have annual screening for depression, discuss all mood changes with their healthcare team, and bring a family member to doctor appointments to discuss mood changes.

Suicidal Behaviour In Ms

Suicidal ideation is very common in MS. In one study, a quarter of clinic attenders with MS had suicidal ideation sometime in the week before their attendance. Around 3% of people with MS will kill themselves. A study of the cause of death in 3000 people with MS over 16 years indicated that 15% of the deaths were recorded as suicide. Other studies have confirmed this increased risk and indicated that additional risk factors for suicide in MS include being male, young age of onset, previous history of depression, social isolation, and substance abuse. A study comparing MS patients with and without lifetime suicidal ideation could distinguish the groups by severity of depression, social isolation, and alcohol abuse. This study also noted that patients with suicidal ideation often were not in receipt of psychiatric evaluation.

The differential diagnosis of depression in MS includes adjustment disorders, paroxysmal changes in mood , and mood changes in relation to drugs for MS.

A number of drugs used to treat MS or its symptoms have been implicated as risk factors for low mood. There are case reports of steroid induced low mood in MS and other disorders. All the anti-spasticity drugs have been associated with low mood . There are also case reports of psychiatric changes following the abrupt discontinuation of baclofen and other anti-spasticity drugs. This means that history taking in respect to depression should include a detailed drug history.

The Case Of Fluvoxamine Maleate

The role of serotonergic drugs in PD associated with depression has been receiving considerable attention amongst the research community . As a link between DA and the development of depression in patients with PD has been suggested, the pathophysiological features of both PD and depression have in common DA pathway dysfunction and depletion and/or 5-HT deficit . It has been suggested that an increase in serotonergic tone may indirectly influence DA function and may contribute to increased motor activity which is partially blocked by DA antagonists . Studies have shown that depression may be associated with an abnormal level of DA . As studies have also shown that brain regions affected by abnormal DA processing may also be affected when 5-HT is abnormally processed, we hypothesize that Fluvoxamine maleate treatment may play a role in improving the chemical imbalance caused by low levels of DA in the brain .

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For Carers Family And Friends

Its important to realise that the effects of depression can spread beyond the individual, affecting the emotions of family, friends and carers. If untreated, depression may continue for years, so it is vital to recognise the condition and seek help.

Often the person with depression may not recognise their symptoms, so it is important that those around them raise their concerns with the person or with his or her doctor, so that depression can be treated.

Further information on how carers and family can look after themselves so that they can continue to care effectively may also be found in the Caring and Parkinson’s section of this website.

Help For Depression And Anxiety

Drug Choices and Advancements for Managing Depression in ...

Depression is a serious matter for anyone. For people with Parkinson’s, it can affect critical elements of disease management such as staying socially connected, exercising and proactively seeking needed care.

It is not always easy to recognize depression in oneself. Be on the lookout for a lack of interest in activities and situations that once brought you joy. Pay attention to observations made by family and friends, and talk to your doctor if you’re not feeling like yourself. Sometimes, your physicians may not even ask you about these conditions if you don’t mention changes in mood or outlook.

Depression and anxiety can be treated with medications, lifestyle changes , and therapy or counseling with a qualified practitioner. Support groups also may be a source of help.

NOTE: If you are in crisis, call the National Suicide Prevention Lifeline at or visit www.suicidepreventionlifeline.org.

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Bta Reduced Sleep Quality Scores

The PSQI scores of the two groups after 2 and 3 months of treatment and 2 months following completion of treatment were lower than those before treatment .

Comparison of sleep quality. There was no significant difference in sleep quality scores between the control group and the observation group before treatment, after 1, 2 and 3 months of treatment, and 2 months after completion of treatment . Compared with those before treatment, both the observation group and the control group exhibited lower sleep quality scores after 2 and 3 months of treatment and 2 months after completion of treatment . *P< 0.05 indicates the comparison between the two groups at different times, P< 0.05.

Depression And Pd: A Non

This 2-page fact sheet explains and recommends cognitive behavioral therapy to manage Parkinsons-related depression. Set goals for daily activities with a focus on exercise, socialization and positive emotional self care. Recognize negative thoughts and implement strategies to minimize them. Work with your care partner to reinforce positive behaviors and implement healthy habits.

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Q: Does Depression Thats Possibly An Early Sign Of Parkinsons Disease Look Or Feel Any Different From Non

A: No, it looks the same. As of yet, we have not identified anything about which we could say, thats linked to Parkinsons theres nothing that allows us to pick those people out of a crowd. Its not specific enough. There are other prodromal symptoms of Parkinsons disease, such as REM sleep behavior disorder , that we can formally diagnose and define and that makes their link to Parkinsons clearer. Our research is trying to find markers in depression or anxiety, for that matter to see if we can find some that are specific to the risk of Parkinsons. Its tough, though, because depression is a lot more variable. Its possible that someday we can identify a combination of depression and other symptoms as a reliable marker for Parkinsons.

The Importance Of Movement

Depression & Anxiety in Parkinson’s and How to Manage Them

Exercise of all kinds can be vitally important for all PD patients, says Dr. Savica. Those who exercise a minimum of 2.5 hours a week significantly slow the decline in their quality of life compared to those who dont. Exercise has also been shown to play a big role in mood. People with PD who exercise more are less likely to experience anxiety or apathy than those who exercise less. Get moving with regular walking, water aerobics, Tai Chi, dance, Pilates, weight traininganything thats enjoyable enough to stick with it long term.

Bottom line: Yes, depression and anxiety are statistic likelihoods with Parkinsons psychosis, but your loved one is not a statistic, and you have options. Start with a call to their doctor to assess treatment options, then consider which therapies and lifestyle enhancements weve outlinedmaybe search for a gentle water-aerobics class or a weekly low-key lunch with friendsmight be doable. It may take trial and error, but there is a very real chance that better days are ahead.

Depression, Anxiety, and Psychosis:Movement Disorders Clinical Practice. Affective Correlates of Psychosis in Parkinsons Disease.

  • Anxiety in PD:Frontiers in Neuroscience. Neuropsychiatric Disorders in Parkinsons Disease: What Do We Know About the Role of Dopaminergic and Non-dopaminergic Systems?

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Depression Linked With Parkinson’s Disease Risk

20 May 2015

People who have been diagnosed with depression may have an increased risk of developing Parkinson’s disease later on, a new study suggests.

In the study, researchers looked at about 140,000 people who had been diagnosed with depression between 1987 and 2012. They matched each of them with three people of the same age and gender who had not been diagnosed with depression. The people in the study were all at least 50 years old by 2005.

The investigators followed the participants for 26 years, and found that 1 percent of the people with depression developed Parkinson’s disease, whereas 0.4 percent of the people without depression developed the disease.

The researchers noted that Parkinson’s disease is not common, even among people with depression. “Only a very little proportion of those with depression develop Parkinson’s disease,” said study author Peter Nordström, of Umeå University in Umeå, Sweden.

Still, the link should be studied further because the new study adds to the growing body of research connecting Parkinson’s disease with certain other health conditions and personality traits. For example, a 2012 study presented at the American Academy of Neurology meeting that year showed that people who are cautious and avoid taking risks are more likely to develop the disease.

The study was published today in the journal Neurology.

How Is Depression Treated

It often is difficult to know how to effectively help a loved one with depression. It is important to have realistic expectations and to give unconditional love. Communication should take place in a positive and honest way. Your loved one may reject attempts to help at first this is part of the illness. Fortunately, treatments are available and are successful in 90 percent of patients with depression.

Depression may be treated with psychological therapy, as well as with medications. Studies show each treatment is effective by itself, but they are much more effective when used together.

There are many antidepressant medications available, each with its own advantages and disadvantages. The choice of antidepressant for patients with Parkinsons disease depends on their overall condition and specific needs. Most antidepressants used for treatment in general are effective in those with Parkinsons disease, although there are some antidepressants that have shown promise in recent studies specifically for Parkinsons disease.

Psychological therapy can help a patient with Parkinsons disease regain a sense of self worth while his or her physical and functional abilities are declining. It also can help the person maintain good relationships with caregivers and family members, even while he or she may have to depend on them even more. It also can help the patient focus on more positive approaches to problem-solving.


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Bta Improved Mmse Score

The MMSE scores did not differ between the two groups before and after treatment , and the MMSE scores were increased significantly in both groups after treatment .

Comparison of cognitive function. There was no significant difference in cognitive function scores between the control group and the observation group before treatment, after 1, 2 and 3 months of treatment, and 2 months after completion of treatment . Compared with before treatment, both the observation group and the control group exhibited higher cognitive function scores after 1, 2 and 3 months of treatment and 2 months after completion of treatment . * indicates comparisons within the observation group, P< 0.05, # indicates comparisons within the control group, P< 0.05.

Mental Health And Parkinson’s


In this 1-hour talk, clinical counselor Courtney Doherty describes depression, anxiety, and apathy — all common changes in mood in Parkinsons disease . And she provides extensive information for how these changes can be treated, particularly in non-pharmacological ways.

In this 30-minute video the presenter, Lisa Mann, RN, MA, BSN, discusses managing depression, anxiety and psychosis.

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Managing Depression In Parkinsons Disease

People with Parkinsons, family members and caregivers may not always recognize the signs of depression and anxiety. If you are experiencing depression as a symptom of Parkinsons, it is important to know it can be treated.

Here are some suggestions:

  • For information and support on living well with Parkinsons disease, contact our Information and Referral line.
  • As much as possible, remain socially engaged and physically active. Resist the urge to isolate yourself.
  • You may want to consult a psychologist and there are medications that help relieve depression in people with Parkinsons, including nortriptyline and citalopram .

Treatment Of Depression In The Setting Of Parkinsons Disease

The evidence base for the treatment of depression in PD is extremely slim. A recent Cochrane library review of treatments for depression in PD reported three randomised controlled trials fulfilling the criteria for inclusion. These trials included a total of 106 patients and indicated that nortryptilline was superior to placebo but that citalopram was not. The review concluded that there were insufficient data on the effectiveness and safety of any antidepressant therapy in Parkinsons disease. There is an urgent need for larger scale clinical trials in this area.

Nevertheless, depression is common in PD and decisions have to be made about treatment. The last 10 years have seen a shift in prescribing practice away from tricyclic antidepressants and towards selective serotonin reuptake inhibitors as a first line treatment of depression in PD. The main reason for this is the more favourable side effect profile of SSRIs.

Tricyclic antidepressants

Selective serotonin reuptake inhibitors

Withdrawal syndromes can occur in people who stop SSRIs suddenly and can include flu-like symptoms, insomnia, nausea, imbalance, sensory disturbance, and hyperarousal . Therefore SSRIs should be reduced slowly.

SSRI withdrawal symptoms

Other treatments for depression

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What The Research Says

Researchers believe that depression and anxiety in Parkinson’s are due to changes in brain chemistry that are caused by the disease itself. The same pathways that create dopamine in the brain which are impacted in PD also create the brain chemical serotonin, which regulates mood, appetite and sleep. Scientists think that the effect of Parkinson’s on serotonin, as well as other brain chemicals that support mood, is responsible for symptoms of depression and anxiety.

The Michael J. Fox Foundation actively pursues research that can shed light on the connection between mood changes and Parkinson’s and lead to treatment breakthroughs for people living with the disease. The MJFF-funded Study of Antidepressants in Parkinson’s Disease found that certain antidepressants eased depression in people with Parkinson’s without worsening movement symptoms. Still, more work remains to find more and better treatments for depression and anxiety. Researchers are looking at several different therapies: medications such as buspirone for anxiety, as well as cognitive behavioral therapy and non-invasive brain stimulation for both depression and anxiety. Join recruiting studies in your area through MJFF’s online tool Fox Trial Finder.

How Do You Know If You Have Depression

The Impact of Depression in Parkinson’s Disease

It can be difficult to determine for yourself if you are depressed, as the symptoms are often similar to what Parkinsons disease can cause.

For example, fatigue, sleep disturbances, motor slowdown and loss of emotional expression can be interpreted as symptoms of depression, when they are likely caused by Parkinsons disease itself.

If you suspect you have symptoms of depression, consult your doctor or a psychologist who can make the diagnosis. He will help you distinguish between the symptoms of depression and those of Parkinsons disease. He will probably have you fill out questionnaires in order to better establish the diagnosis.

You can also take your own depression test and bring the results to your doctor or psychologist.

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What Are The Signs Of Depression

If you have several of the following symptoms for longer than two weeks at a time, you should contact your doctor:

  • Depressed mood
  • Loss of interest or pleasure in activities
  • Sleep disturbances
  • Change in appetite
  • Sudden change in level of physical activity
  • Difficulty with concentration or making decisions
  • Irritability

There also are physical signs of depression, which include:

  • Downcast eyes
  • Flattened expressions
  • Slower movement or fatigue that may be similar to the symptoms of Parkinsons disease

This often makes it a challenge to diagnose depression in someone with Parkinsons disease. In addition, depression can actually make the physical effects of Parkinsons disease worse, so its important to recognize and treat these symptoms right away.

Factors Associated With Pd

Binary logistic regression analysis was performed using the above variables that found statistical differences between PD-D and PD-ND groups. The results showed that the scores of UPDRS III, PIGD type, and the scores of HAMA and FS were independently associated with PD-D .

Table 3. Logistic regression analysis of factors associated with PD-D.

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Finding The Right Treatment

One hallmark of PD is the reduction of dopamine, the neurotransmitter involved in controlling movement, kidney function, sleep, motivation, learning, and pleasure. So a first-line treatment is dopamine agonists , medications that mimic the neurotransmitter’s actions and restore normal movement and mood. Over time, though, the same medicine that saved your loved ones life may cruelly turn on them. After many years, these drugs can cause hallucinations, paranoia, compulsion, and memory loss, says Dr. Savica. If so, he starts fresh with a whole new, non-DA drug regimen. There are a lot of ways we can tailor the treatment to the patient. Psychosis is not always an eventuality.

Depression and/or anxiety might be treated with antidepressants by the neurologist, but most doctors will also recommend talk therapy. Since symptoms of psychosis generally first appear between ages 55 and 65 and become more common in people ages 70+, its worthwhile finding a psychologist or psychiatrist who specializes in geriatrics, says Dr. Savica. In one study, PD patients who received cognitive-behavioral therapy by geriatric therapists experienced significantly less depression than those who didn’t. One caveat: Therapy wont help with psychosis symptoms, says Dr. Quinn, but it can help ease the associated depression and anxiety.

What Are The Treatment Options For Depression


Just as the symptoms and causes of depression can differ from person to person, so too can suitable treatment approaches. There are two main types of treatment options for depression: antidepressant medications and psychological counseling .

The Parkinsons Foundation recommends a holistic, comprehensive approach to depression. Although antidepressants are often effective in reducing symptoms, they should seldom be used alone. In most cases, the best approach is a combination of antidepressant medication, counseling, exercise and social support.

How can you ease depression in PD? First, share your concerns with your doctor. Many movement disorders specialists now include questions about depression in their exams. If your doctor does not, raise the topic. He or she may recommend medical or nonmedical coping strategies, including the following:

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