Depression and Parkinson’s disease


Depression occurs in approximately 45% of all patients with Parkinson’s disease (PD), reduces quality of life independent of motor symptoms and seems to be underrated and undertreated. Characteristics of symptoms differ from major depression. Because of overlapping clinical symptoms, diagnosis is based on subjectively experienced anhedonia and feeling of emptiness. Available rating scales for major depression may not be adequate to correctly measure severity of depression in PD. Anxiety and depression may manifest as first symptoms of PD many years before motor symptoms. Serotonergic, noradrenergic and dopaminergic mechanisms play key roles in the etiology of depression in PD. Tricyclic and newer, selective antidepressants including serotonin and noradrenaline reuptake inhibitors (SSRI, SNRI) appear to be effective in treating depression in PD. Selective reuptake inhibitors seem to have a favorable side effect profile. Recent controlled studies show antidepressant effects of pramipexole in bipolar II depression. New dopamine agonists pramipexole and ropinirole appear to ameliorate depressive symptoms in PD in addition to effects on motor symptoms. There is a lack of appropriate rating scales and controlled studies regarding depression in PD.

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  1. 1.

    Cummings JL, Masterman DL (1999) Depression in patients with Parkinson’s disease. Int J Geriatr Psychiatry 14:711–718

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Kumar R, Krack P, Pollak P (1999) Transient acute depression induced by highfrequency deep-brain stimulation. N Engl J Med 341:1003–1004

    Article  CAS  Google Scholar 

  3. 3.

    Lemke MR (2002) Effect of reboxetine on depression in Parkinson’s disease. J Clin Psychiatry 63:300–304

    CAS  PubMed  Google Scholar 

  4. 4.

    Lemke MR (1999) Motor signs of depression. Nervenarzt 70:600–612

    Article  CAS  PubMed  Google Scholar 

  5. 5.

    Lemke MR, Brecht HM, Koester J, Kraus PH, Reichmann H (2004) Anhedonia, depression, and motor functioning in Parkinson’s disease during treatment with pramipexole. J Neuropsychiat Clin Neurosciences (in press)

  6. 6.

    Oertel WH, Ellgring H (1995) Parkinson’s disease-medical education and psychosocial aspects. Patient Educ Couns 26:71–79

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Richard IH, Kurlan R (1997) A survey of antidepressant drug use in Parkinson’s disease. Parkinson Study Group. Neurology 49:1168–1170

    Google Scholar 

  8. 8.

    Richard IH, Maughn A, Kurlan R (1999) Do serotonin reuptake inhibitor antidepressants worsen Parkinson’s disease? A retrospective case series. Mov Disord 14:155–157

    Article  CAS  PubMed  Google Scholar 

  9. 9.

    Reichmann H, Brecht MH, Koster J, Kraus PH, Lemke MR (2003) Pramipexole in routine clinical practice: a prospective observational trial in Parkinson’s disease. CNS Drugs 17: 965–973

    CAS  PubMed  Google Scholar 

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Correspondence to Matthias R. Lemke MD.

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Lemke, M.R., Fuchs, G., Gemende, I. et al. Depression and Parkinson’s disease. J Neurol 251, vi24–vi27 (2004).

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Key words

  • antidepressant
  • depression
  • dopamine agonists
  • Parkinson’s disease
  • psychotherapy