Depression in patients with Parkinson's disease - Epidemiology, pathophysiology and treatment options

The evaluation and treatment of depression is an important component of the management of individuals with Parkinson's disease, This review summarises current knowledge on the epidemiology, pathophysiology and treatment of de pression in Parkinson's disease, Limited information is available regarding the pathophysiology of depressio n in Parkinson's disease and the effectiveness of treatment. Selective sero tonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs) are commonly used but more information is needed regarding their tolerability and antide pressant efficacy in patients with Parkinson's disease, and their effect on motor function. Antidepressants can interact with selegiline (deprenyl) to cause the 'serotonin syndrome', although retrospective chart reviews indic ate that this is ran. While several case reports have noted worsening parki nsonian motor features with SSRI use, open-label prospective studies have n ot substantiated these findings. Further double-blind, prospective studies would be valuable to further evaluate the tolerability and efficacy of anti depressants in Parkinson's disease.