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[Psychic disorders].

P Pollak1

  • 1Département de Neurologie, Centre Hospitalier Universitaire de Grenoble, INSERM U 318, Université Joseph Fourier de Grenoble, 38043 Grenoble.

Revue Neurologique
|April 15, 2003
PubMed
Summary
This summary is machine-generated.

Selective Serotonin Reuptake Inhibitors are recommended for depression in Parkinson's disease (PD). Psychosis treatment involves reducing PD medications, with clozapine and quetiapine as potential antipsychotic options.

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Area of Science:

  • Neuropsychiatry
  • Movement Disorders
  • Pharmacology

Context:

  • Parkinson's disease (PD) is characterized by significant neuropsychiatric symptoms, including depression and psychosis.
  • These symptoms often arise from a combination of neuropathological changes and antiparkinsonian drug side effects.
  • Current treatment guidelines for depression in PD are not well-established.

Purpose:

  • To review the current understanding and treatment strategies for depression and psychosis in Parkinson's disease.
  • To evaluate the efficacy and safety of various pharmacological interventions.
  • To provide guidance on managing these complex neuropsychiatric comorbidities.

Summary:

  • Depression in Parkinson's disease (PD) is frequently treated with Selective Serotonin Reuptake Inhibitors (SSRIs), though careful monitoring for potential parkinsonism worsening or agitation is necessary.

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  • Psychosis management involves dose reduction of antiparkinsonian drugs. If symptoms persist with levodopa monotherapy, antipsychotics are considered.
  • Clozapine is FDA-approved for PD psychosis, demonstrating efficacy without parkinsonism exacerbation. Quetiapine shows similar potential, while olanzapine and risperidone carry risks and are reserved for last resort.

    • Impact:

    • This review offers critical insights into managing challenging neuropsychiatric symptoms in Parkinson's disease patients.
    • It highlights the need for tailored pharmacological approaches, balancing efficacy with potential side effects.
    • Informing clinical practice for improved patient outcomes in Parkinson's disease management.