Drugs & Aging

, Volume 12, Issue 1, pp 55–74 | Cite as

Depression in Parkinson’s Disease

Pharmacological Characteristics and Treatment
  • Tiffany Tom
  • Jeffrey L. Cummings
Review Article Disease Management

Summary

Parkinson’s disease (PD) is a common neurological illness and various degrees of depression frequently complicate its course. Risk factors for developing depression with PD include right-sided hemiparkinsonism, akinesia, increased severity of disability, anxiety and psychosis. Onset of parkinsonism at a younger age, female gender and the use of levodopa are arguable risk factors. Depression may be difficult to diagnose in patients with PD because the signs of the 2 disorders overlap. In addition, patients with atypical PD more commonly have depression than patients with classical PD presentations.

Antidepressant response to antiparkinsonian treatment has been limited. Enhancement of catecholamine levels in the CNS by selegiline (deprenyl), a monoamine oxidase (MAO) type B inhibitor, has shown potential antidepressant as well as neuroprotective effects. Other MAO inhibitors have shown antidepressant efficacy in animal models but have not been well tolerated by patients with PD. A catechol-O-methyltransferase (COMT) inhibitor combined with an MAO inhibitor might synergistically maximise the levels of catecholamines in the CNS.

Antidepressant medications used in patients without PD include tricyclic antidepressants (TCAs) and selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs), but only TCAs have been carefully studied for their antidepressant effects in PD. Electroconvulsive therapy has proven efficacy as antidepressant therapy in patients with PD, and transcranial magnetic stimulation has provided temporary relief of depression under experimental conditions.

Adverse effects of polypharmacy in the attempted treatment of depression in patients with PD are common in the elderly. A ‘serotonin syndrome’ has occurred frequently enough to preclude the coadministration of selegiline with SSRIs or TCAs, and multiple interactions between antiparkinsonian and antidepressant medications further complicate treatment strategies in patients with PD.

An algorithmic approach to the pharmacological treatment of depression is described in this article.

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References

  1. 1.
    Mayeux R, Denaro J, Hemenegildo N, et al. A population-based investigation of Parkinson’s disease with and without dementia: relationship to age and gender. Arch Neurol 1992; 49: 492–7PubMedGoogle Scholar
  2. 2.
    Adams RD, Victor M. Principles of neurology. 4th ed. New York: McGraw-Hill, 1989Google Scholar
  3. 3.
    Harvey NS. Psychiatric disorders in parkinsonism: 1. Functional illnesses and personality. Psychosomatics 1986; 27: 91–103PubMedGoogle Scholar
  4. 4.
    Friedenberg DL, Cummings JL. Parkinson’s disease, depression, and the on-off phenomenon. Psychosomatics 1989; 30: 94–9PubMedGoogle Scholar
  5. 5.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Washington, DC: American Psychiatric Association, 1984Google Scholar
  6. 6.
    Tandberg E, Larsen JP, Aarsland D, et al. The occurrence of depression in Parkinson’s disease: a community-based study. Arch Neurol 1996; 53: 175–9PubMedGoogle Scholar
  7. 7.
    Rodin G, Voshart K. Depression in the medically ill: an overview. Am J Psychiatry 1986; 143: 695–705Google Scholar
  8. 8.
    Santamaria J, Tolosa E. Clinical subtypes of Parkinson’s disease and depression. In: Huber SJ, Cummings JL, editors. Parkinson’s disease: neurobehavioral aspects. New York: Oxford University Press, 1992: 217–8Google Scholar
  9. 9.
    Santamaria J, Tolosa E, Valle A. Parkinson’s disease with depression: a possible subgroup of idiopathic parkinsonism. Neurology 1986; 36: 1130–3PubMedGoogle Scholar
  10. 10.
    Cole SA, Woodard JL, Juncos JL, et al. Depression and disability in Parkinson’s disease. J Neuropsychiatry Clin Neurosci 1996; 8: 20–5PubMedGoogle Scholar
  11. 11.
    Kostic VS, Filipovic SR, Lecic D, et al. Effect of age at onset on frequency of depression in Parkinson’s disease. J Neurol Neurosurg Psychiatry 1994; 57: 1265–7PubMedGoogle Scholar
  12. 12.
    Starkstein SE, Berthier ML, Bolduc PL, et al. Depression in patients with early versus late onset of Parkinson’s disease. Neurology 1989; 39: 1441–5PubMedGoogle Scholar
  13. 13.
    Wagner ML, Fedak MN, Sage JI, et al. Complications of disease and therapy: a comparison of younger and older patients with Parkinson’s disease. Ann Clin Lab Sci 1996; 26: 389–95PubMedGoogle Scholar
  14. 14.
    Gibb WRG, Lees AJ. A comparison of clinical and pathological features of young- and old-onsetParkinson’s disease. Neurology 1988; 38: 1402–6PubMedGoogle Scholar
  15. 15.
    Taylor AE, Saint-Cyr JA. Depression in Parkinson’s disease: reconciling physiological and psychological perspectives. J Neuropsychiatry Clin Neurosci 1990; 2: 92–8PubMedGoogle Scholar
  16. 16.
    Brown R, Jahanshahi M. Depression in Parkinson’s disease: a psychosocial viewpoint. Adv Neurol 1995; 65: 61–84PubMedGoogle Scholar
  17. 17.
    Miyoshi K, Ueki A, Nagano O. Management of psychiatric symptoms of Parkinson’s disease. Eur Neurol 1996; 36Suppl. 1: 49–54PubMedGoogle Scholar
  18. 18.
    Henderson S. Epidemiology of psychiatric disorders. In: Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry. 6th ed. Baltimore: Williams and Wilkins, 1995: 2513–9Google Scholar
  19. 19.
    Barber J, Tomer R, Sroka H, et al. Does unilateral dopamine deficit contribute to depression? Psychiatry Res 1985; 15: 17–24PubMedGoogle Scholar
  20. 20.
    Vogel H-P. Symptoms of depression in Parkinson’s disease. Pharmacopsychiatry 1982; 15: 192–6Google Scholar
  21. 21.
    Cummings JL. Neuropsychiatric complications of drug treatment of Parkinson’s disease. In: Huber SJ, Cummings JL, editors. Parkinson’s disease: neurobehavioral aspects. New York: Oxford University Press, 1992: 313–27Google Scholar
  22. 22.
    Shaw AM, Lees AJ, Stern GM. The impact of treatment with levodopa on Parkinson’s disease. Q J Med 1980; 49: 283–93PubMedGoogle Scholar
  23. 23.
    Goodwin FK. Behavioral effects of L-dopa in man. Semin Psychiatry 1971; 3: 477–92PubMedGoogle Scholar
  24. 24.
    Silver JM, Yudofsky SC. Drug treatment of depression in Parkinson’s disease. In: Huber SJ, Cummings JL, editors. Parkinson’s disease: neurobehavioral aspects. New York: Oxford University Press, 1992: 240–54Google Scholar
  25. 25.
    Cherington M. Parkinsonism, L-dopa and mental depression. J Am Geriatr Soc 1970; 18: 513–6PubMedGoogle Scholar
  26. 26.
    Schiffer RB, Kurlan R, Rubin A, et al. Evidence for atypical depression in Parkinson’s disease. Am J Psychiatry 1988; 145: 1020–2PubMedGoogle Scholar
  27. 27.
    Richard IH, Schiffer RB, Kurlan R. Anxiety and Parkinson’s disease. J Neuropsychiatry Clin Neurosci 1996; 8: 383–92PubMedGoogle Scholar
  28. 28.
    Factor SA, Molho ES, Podskalny GD, et al. Parkinson’s disease: drug-induced psychiatric states. Adv Neurol 1995; 65: 115–38PubMedGoogle Scholar
  29. 29.
    Menza MA, Rosen RC. Sleep in Parkinson’s disease: the role of depression and anxiety. Psychosomatics 1995; 36: 262–6PubMedGoogle Scholar
  30. 30.
    Tandberg E, Larsen JP, Aarsland D, et al. Risk factors for depression in Parkinson disease. Arch Neurol 1997; 54: 625–30PubMedGoogle Scholar
  31. 31.
    Troester AI, Paolo AM, Lyons KE, et al. The influence of depression on cognition in Parkinson’s disease: a pattern of impairment distinguishable from Alzheimer’s disease. Neurology 1995; 45: 672–5Google Scholar
  32. 32.
    Troester AI, Stalp LD, Paolo AM, et al. Neuropsychological impairment in Parkinson’s disease with and without depression. Arch Neurol 1995; 52: 1164–9Google Scholar
  33. 33.
    Kuzis G, Sabe L, Tiberti C, et al. Cognitive functions in major depression and Parkinson disease. Arch Neurol 1997; 54: 982–6PubMedGoogle Scholar
  34. 34.
    Wertman E, Speedie L, Shemesh Z, et al. Cognitive disturbances in parkinsonian patients with depression. Neuropsych Neuropsychol Behav Neurol 1993; 6: 31–7Google Scholar
  35. 35.
    Taylor AE, Saint-Cyr JA, Lang AE, et al. Parkinson’s disease and depression. Brain 1986; 109: 279–92PubMedGoogle Scholar
  36. 36.
    Cummings JL. Depression and Parkinson’s disease: a review. Am J Psychiatry 1992; 149: 443–54PubMedGoogle Scholar
  37. 37.
    Keshavan MS, David AS, Narayanen HS,et al. ‘On-off’ phenomena and manic-depressive mood shifts: case report. J Clin Psychiatry 1986; 47: 93–4PubMedGoogle Scholar
  38. 38.
    Sandyk R. Locus ceruleus-pineal melatonin interactions and the pathogenesis of the ‘On-off’ phenomenon associated with mood changes and sensory symptoms in Parkinson’s disease. Int J Neurosci 1989; 49: 95–101PubMedGoogle Scholar
  39. 39.
    Mayberg HS, Starkstein SE, Sadzot B, et al. Selective hypometabolism in the inferior frontal lobe in depressed patients with Parkinson’s disease. Ann Neurol 1990; 28: 57–64PubMedGoogle Scholar
  40. 40.
    Bissessur S, Tissingh G, Wolters EC, et al. rCBF SPECT in Parkinson’s disease patients with mental dysfunction. J Neural Transm Suppl 1997; 50: 25–30PubMedGoogle Scholar
  41. 41.
    Ring HA, Bench CJ, Trimble MR, et al. Depression in Parkinson’s disease: a positron emission study. Br J Psychiatry 1994; 165: 333–9PubMedGoogle Scholar
  42. 42.
    Starkstein SE, Mayberg HS, Leiguarda R, et al. A prospective longitudinal study of depression, cognitive decline, and physical impairments in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 1992; 55: 377–82PubMedGoogle Scholar
  43. 43.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association, 1994Google Scholar
  44. 44.
    Larsen JP, Dupont E, Tandberg E. Clinical diagnosis of Parkinson’s disease: proposal of diagnostic subgroups classified at different levels of confidence. Acta Neurol Scand 1994; 89: 242–51PubMedGoogle Scholar
  45. 45.
    de Rijk MC, Rocca WA, Anderson DW, et al. A population perspective on diagnostic criteria for Parkinson’s disease. Neurology 1997; 48: 1277–81PubMedGoogle Scholar
  46. 46.
    Sano M, Mayeux R. Biochemistry of depression in Parkinson’s disease. In: Huber SJ, Cummings JL, editors. Parkinson’s disease: neurobehavioral aspects. New York: Oxford University Press, 1992: 229–39Google Scholar
  47. 47.
    Mayeux R, Stern Y, Williams JBW, et al. Clinical and biochemical features of depression in Parkinson’s disease. Am J Psychiatry 1986; 143: 756–9PubMedGoogle Scholar
  48. 48.
    Frochtengarten ML, Villares JCB, Maluf E, et al. Depressive symptoms and the dexamethasone suppression test in parkinsonian patients. Biol Psychiatry 1987; 22: 386–9PubMedGoogle Scholar
  49. 49.
    Rabey JM, Scharf M, Oberman Z, et al. Cortisol, ACTH, and beta-endorphin after dexamethasone administration in Parkinson’s dementia. Biol Psychiatry 1990; 27: 581–91PubMedGoogle Scholar
  50. 50.
    Mayberg HS, Solomon DH. Depression in Parkinson’s disease: a biochemical and organic viewpoint. Adv Neurol 1995; 65: 49–60PubMedGoogle Scholar
  51. 51.
    Javoy-Agid F, Agid Y. Is the mesocortical dopaminergic system involved in Parkinson disease? Neurology 1980; 30: 1326–30PubMedGoogle Scholar
  52. 52.
    Fibiger HC. The neurobiological substrates of depression in Parkinson’s disease: a hypothesis. Can J Neurol Sci 1984; 11: 105–7PubMedGoogle Scholar
  53. 53.
    Cantello R, Aguggia M, Gilli M, et al. Major depression in Parkinson’s disease and the mood response to intravenous methylphenidate: possible role of the ‘hedonic’ dopamine synapse. J Neurol Neurosurg Psychiatry 1989; 52: 724–31PubMedGoogle Scholar
  54. 54.
    Mayeux R, Stern Y, Cote L, et al. Altered serotonin metabolism in depressed patients with Parkinson’s disease. Neurology 1984; 34: 642–6PubMedGoogle Scholar
  55. 55.
    Mayeux R, Stern Y, Sano M, et al. The relationship of serotonin to depression in Parkinson’s disease. Mov Disord 1988; 3: 237–44PubMedGoogle Scholar
  56. 56.
    Wolfe N, Katz DI, Albert ML, et al. Neuropsychological profile linked to low dopamine in Alzheimer’s disease, major depression, and Parkinson’s disease. J Neurol Neurosurg Psychiatry 1990; 53: 915–7PubMedGoogle Scholar
  57. 57.
    Sano M, Stern Y, Cote L, et al. Depression in Parkinson’s disease: a biochemical model. J Neuropsychiatry Clin Neurosci 1990; 2: 88–92PubMedGoogle Scholar
  58. 58.
    Schneider LS, Chui HC, Severson JA, et al. Decreased platelet 3H-imipramine binding in Parkinson’s disease. Biol Psychiatry 1988; 24: 348–51PubMedGoogle Scholar
  59. 59.
    Cash R, Raisman R, Ploska A, et al. High and low affinity [3H]imipramine binding sites in control and parkinsonian brains. Eur J Pharmacol 1985; 117: 71–80PubMedGoogle Scholar
  60. 60.
    D’Amato RJ, Zweig RM, Whitehouse PJ, et al. Aminergic systems in Alzheimer’s disease and Parkinson’s disease. Ann Neurol 1986; 22: 229–36Google Scholar
  61. 61.
    Raisman R, Cash R, Agid Y. Parkinson’s disease: decreased density of 3H-imipramine and 3H-paroxetine binding sites in putamen. Neurology 1986; 36: 556–60PubMedGoogle Scholar
  62. 62.
    Mena MA, Aguado EG, de Yebenes JG. Monoamine metabolites in human cerebrospinal fluid: HPLC/ED method. Acta Neural Scand 1984; 69: 218–25Google Scholar
  63. 63.
    Kostic VS, Djuricic BM, Covickovic-Sternic N, et al. Depression and Parkinson’s disease: possible role of serotonergic mechanisms. J Neural 1987; 234: 94–6Google Scholar
  64. 64.
    Chia LG, Cheng FC, Kuo JS. Monoamines and their metabolites in plasma and lumbar cerebrospinal fluid of Chinese patients with Parkinson’s disease. J Neurol Sci 1993; 116: 125–34PubMedGoogle Scholar
  65. 65.
    Bell IR, Amend D, Kaszniak AW, et al. Trait shyness in the elderly: evidence for an association with Parkinson’s disease in family members and biochemical correlates. J Geriatr Psychiatry Neurol 1995; 8: 16–22PubMedGoogle Scholar
  66. 66.
    Menza MA, Mark MH. Parkinson’s disease and depression: the relationship to disability and personality. J Neuropsychiatry Clin Neurosci 1993; 6: 165–9Google Scholar
  67. 67.
    Chan-Palay V, Asan E. Alterations in catecholamine neurons of the locus coeruleus in senile dementia of the Alzheimer type and in Parkinson’s disease with and without dementia and depression. J Comp Neurol 1989; 287: 373–92PubMedGoogle Scholar
  68. 68.
    Chan-Palay V. Depression and dementia in Parkinson’s disease: catecholamine changes in the locus ceruleus, a basis for therapy. Adv Neurol 1993; 60: 438–46PubMedGoogle Scholar
  69. 69.
    Mindham RHS, Marsden CD, Parkes JD. Psychiatric symptoms during L-dopa therapy for Parkinson’s disease and their relationship to physical disability. Psychol Med 1976; 6: 23–33PubMedGoogle Scholar
  70. 70.
    Jouvent R, Abensour P, Bonnet AM, et al. Antiparkinsonian and antidepressant effects of high doses of bromocriptine. J Affect Disord 1983; 5: 141–5PubMedGoogle Scholar
  71. 71.
    Muscat R, Papp M, Willner P. Antidepressant-like effects of dopamine agonists in an animal model of depression. Biol Psychiatry 1992; 31: 937–46PubMedGoogle Scholar
  72. 72.
    Moryl E, Danysz W, Quack G. Potential antidepressive properties of amantadine, memantine and bifemelane. Pharmacol Toxicol 1993; 72: 394–7PubMedGoogle Scholar
  73. 73.
    Huszonek JJ. Anticholinergic effects in a depressed parkinsonian patient. J Geriatr Psychiatry Neurol 1995; 8: 100–2PubMedGoogle Scholar
  74. 74.
    Kuhn W, Muller T. The clinical potential of deprenyl in neurologic and psychiatric disorders. J Neural Transm Suppl 1996; 48: 85–93PubMedGoogle Scholar
  75. 75.
    Reynolds GP, Elsworth JD, Blau K, et al. Deprenyl is metabolised to methamphetamine and amphetamine in man. Br J Clin Pharmacol 1978; 6: 542–4PubMedGoogle Scholar
  76. 76.
    Baronti F, Davis TL, Boldry RC, et al. Deprenyl effects on levodopa pharmacodynamics, mood, and free radical scavenging. Neurology 1992; 42: 541–4PubMedGoogle Scholar
  77. 77.
    Brown AS, Gershon S. Dopamine and depression. J Neural Transm 1993; 91: 75–109Google Scholar
  78. 78.
    Parkinson Study Group. Effect of deprenyl of the progression of disability in early Parkinson’s disease. N Engl J Med 1989; 321: 1364–71Google Scholar
  79. 79.
    Przuntek H, Kuhn W, Kraus P. The effect of R-(−)-deprenyl in de novo parkinsonian patients pretreated with levodopa and decarboxylase inhibitor correlated to depression and MHPG, HIAA, and HVA levels in the cerebrospinal fluid. Acta Neurol Scand Suppl 1989; 126: 153–6PubMedGoogle Scholar
  80. 80.
    Allain H, Pollak P, Neukirch HC. Symptomatic effect of selegiline in de novo parkinsonian patients: the French Selegiline Multicenter Trial. Mov Disord 1993; 8Suppl. 1: S36–40PubMedGoogle Scholar
  81. 81.
    Hoffman WE. Treatment of major depression and Parkinson’s disease with combined phenelzine and amantadine [letter]. Am J Psychiatry 1985; 142: 273Google Scholar
  82. 82.
    Hargrave R, Ashford JW. Phenelzine treatment of depression in Parkinson’s disease. Am J Psychiatry 1992; 149: 1751–2PubMedGoogle Scholar
  83. 83.
    Lavian G, Finberg JPM, Youdim MBH. The advent of a new generation of monoamine oxidase inhibitor antidepressants: pharmacologic studies with moclobemide and brofaromine. Clin Neuropharmacol 1993; 16Suppl. 2: S1–7PubMedGoogle Scholar
  84. 84.
    Haefely W, Burkard WP, Cesura A, et al. Pharmacology of moclobemide. Clin Neuropharmacol 1993; 16Suppl. 2: S8–18PubMedGoogle Scholar
  85. 85.
    Waldmeier PC, Glatt A, Jaekel J, et al. Brofaromine: a monoamine oxidase-A and serotonin uptake inhibitor. Clin Neuropharmacol 1993; 16Suppl. 2: S19–24PubMedGoogle Scholar
  86. 86.
    Mannisto PT, Lang A, Rauhala P, et al. Beneficial effects of co-administration of catechol-O-methyltransferase inhibitors and L-dihydroxyphenylalanine in rat models of depression. Eur J Pharmacol 1995; 274: 229–33PubMedGoogle Scholar
  87. 87.
    Illi A, Sundberg S, Ojala-Karlsson P, et al. Simultaneous inhibition of catechol-O-methyltransferase and monoamine oxidase A: effects on hemodynamics and catecholamine metabolism in healthy volunteers. Clin Pharmacol Ther 1996; 59: 450–7PubMedGoogle Scholar
  88. 88.
    Klockgether T, Loschmann PA, Wullner U. New medical and surgical treatments for Parkinson’s disease. Curr Opin Neurol 1994; 7(4): 346–52PubMedGoogle Scholar
  89. 89.
    Price LH, Spencer DD, Marek KL, et al. Psychiatric status after human fetal mesencephalic tissue transplantation in Parkinson’s disease. Biol Psychiatry 1995; 38: 498–505PubMedGoogle Scholar
  90. 90.
    Masterman DL, Bronstein J, DeSalles AF, et al. Cognitive and behavioral performance following unilateral ventroposterior pallidotomy. Neurology 1997; 48: A252–3Google Scholar
  91. 91.
    Warburton JW. Depressive symptoms in Parkinson’s patients referred for thalamotomy. J Neurol Neurosurg Neuropsychiatry 1967; 30: 368–70Google Scholar
  92. 92.
    Klaassen T, Verhey FRJ, Sneijders GHJM, et al. Treatment of depression in Parkinson’s disease: a meta-analysis. J Neuropsychiatry Clin Neurosci 1995; 7: 281–6PubMedGoogle Scholar
  93. 93.
    Mandell AJ, Markham C, Fowler W. Parkinson’s syndrome, depression and imipramine: a preliminary report. Calif Med 1961; 95: 12–4PubMedGoogle Scholar
  94. 94.
    Denmark JC, David JDP, McComb SG. Imipramine hydrochloride (Tofranil) in parkinsonism: a preliminary report. Br J Clin Pract 1961; 15: 523–4PubMedGoogle Scholar
  95. 95.
    Gillhespy RO, Mustard DM. The evaluation of imipramine in the treatment of Parkinson’s disease. Br J Clin Pract 1963; 17: 205–8PubMedGoogle Scholar
  96. 96.
    Strang RR. Imipramine in treatment of parkinsonism: a double-blind placebo study. BMJ 1965; 2: 33–4PubMedGoogle Scholar
  97. 97.
    Cunningham LA. Depression in the medically ill: choosing an antidepressant. J Clin Psychiatry 1994; 55Suppl. A: 90–7; discussion 98-100PubMedGoogle Scholar
  98. 98.
    Drevets WC. Geriatric depression: brain imaging correlates and pharmacologie considerations. J Clin Psychiatry 1994; 55Suppl. A: 71–81; discussions 82, 98-100PubMedGoogle Scholar
  99. 99.
    Stoudemire A. New antidepressant drugs and the treatment of depression in the medically ill patient. Psychiatr Clin North Am 1996; 19: 495–514PubMedGoogle Scholar
  100. 100.
    McCance-Katz EF, Marek KL, Price LH. Serotonergic dysfunction in depression associated with Parkinson’s disease. Neurology 1992; 42: 1813–4PubMedGoogle Scholar
  101. 101.
    Steur ENHJ. Increase of Parkinson disability after fluoxetine medication. Neurology 1993; 43: 211–3PubMedGoogle Scholar
  102. 102.
    Ludwig CL, Weinberger DR, Bruno G, et al. Buspirone, Parkinson’s disease, and the locus ceruleus. Clin Neuropharmacol 1986; 9: 373–8PubMedGoogle Scholar
  103. 103.
    Fontaine R, Ontiveros A, Elle R, et al. A double-blind comparison of nefazodone, imipramine, and placebo in major depression. J Clin Psychiatry 1994; 55: 234–41PubMedGoogle Scholar
  104. 104.
    Montgomery SA. Efficacy in long-term treatment of depression. J Clin Psychiatry 1996; 57Suppl. 2: 24–30PubMedGoogle Scholar
  105. 105.
    Kasper S. Clinical efficacy of mirtazapine: a review of meta-analyses of pooled data. Int Clin Psychopharmacol 1995; 10Suppl. 4: 25–35PubMedGoogle Scholar
  106. 106.
    Marttila M, Jaaskelainen J, Jarvi R, et al. A double-blind study comparing the efficacy and tolerability of mirtazapine and doxepin in patients with major depression. Eur Neuropsychopharmacol 1995; 5: 441–6PubMedGoogle Scholar
  107. 107.
    Goetz CG, Tanner CM, Klawans HL. Bupropion in Parkinson’s disease. Neurology 1984; 34: 1092–4PubMedGoogle Scholar
  108. 108.
    Preskorn SH, Othmer SC. Evaluation of bupropion hydrochloride: the first of a new class of atypical antidepressants. Pharmacotherapy 1984; 4: 20–34PubMedGoogle Scholar
  109. 109.
    Martin P, Massol J, Puech AJ. Captopril as an antidepressant? Effects on the learned helplessness paradigm in rats. Biol Psychiatry 1990; 27: 968–74PubMedGoogle Scholar
  110. 110.
    Khawaja AM, Rogers DF. Tachykinins: receptor to effector. Int J Biochem Cell Biol 1996; 28: 721–38PubMedGoogle Scholar
  111. 111.
    Rasmussen KG, Abrams R. The role of electroconvulsive therapy in Parkinson’s disease. In: Huber SJ, Cummings JL, editors. Parkinson’s disease: neurobehavioral aspects. New York: Oxford University Press, 1992: 255–70Google Scholar
  112. 112.
    Atre-Vaidya N, Jampala VC. Electroconvulsive therapy in parkinsonism with affective disorder. Br J Psychiatry 1988; 152: 55–8PubMedGoogle Scholar
  113. 113.
    Douyon R, Serby M, Klutchko B, et al. ECT and Parkinson’s disease revisited: a ‘naturalistic’ study. Am J Psychiatry 1989; 146: 1451–5PubMedGoogle Scholar
  114. 114.
    Holcomb HH, Sternberg DE, Heninger GR. Effects of electroconvulsive therapy on mood, parkinsonism, and tardive dyskinesia in a depressed patient: ECT and dopamine systems. Biol Psychiatry 1983; 18: 865–73PubMedGoogle Scholar
  115. 115.
    Lebensohn ZM, Jenkins RB. Improvement of parkinsonism in depressed patients treated with ECT. Am J Psychiatry 1975; 132: 283–385PubMedGoogle Scholar
  116. 116.
    Asnis G. Parkinson’s disease, depression, and ECT: a review and case study. Am J Psychiatry 1977; 134: 191–5PubMedGoogle Scholar
  117. 117.
    Burke WJ, Peterson J, Rubin EH. Electroconvulsive therapy in the treatment of combined depression and Parkinson’s disease. Psychosomatics 1988; 29: 341–6PubMedGoogle Scholar
  118. 118.
    Balldin J, Granerus A, Linstedt G, et al. Predictors for improvement after electroconvulsive therapy in parkinsonian patients with on-off symptoms. J Neural Transm 1981; 52: 199–211PubMedGoogle Scholar
  119. 119.
    Fromm GH. Observations on the effect of electroshock treatment on patients with parkinsonism. Bull Tulane Univ 1959; 18: 71–3Google Scholar
  120. 120.
    Faber R, Trimble MR. Electroconvulsive therapy in Parkinson’s disease and other movement disorders. Mov Disord 1991; 6: 293–303PubMedGoogle Scholar
  121. 121.
    Figiel GS, Hassen MA, Zorumski C, et al. ECT-induced delirium in depressed patients with Parkinson’s disease. J Neuropsychiatry Clin Neurosci 1991; 3: 405–11PubMedGoogle Scholar
  122. 122.
    Figiel GS, Coffey CE, Djang WT, et al. Brain magnetic resonance imaging findings in ECT-induced delirium. J Neuropsychiatry Clin Neurosci 1990; 2: 53–8PubMedGoogle Scholar
  123. 123.
    George MS, Wassermann EM, Post RM. Transcranial magnetic stimulation: a neuropsychiatric tool for the 21st century. J Neuropsychiatry Clin Neurosci 1996; 8: 373–82PubMedGoogle Scholar
  124. 124.
    Sandyk R, Derpapas K. The effects of external pico Tesla range magnetic fields on the EEG in Parkinson’s disease. Int J Neurosci 1993; 70: 85–96PubMedGoogle Scholar
  125. 125.
    Fischer PA, Baas H. Therapeutic efficacy of R-(−) deprenyl as adjuvant therapy in advanced parkinsonism. J Neural Transm Suppl 1987; 25: 137–47PubMedGoogle Scholar
  126. 126.
    Lees A, Shaw KM, Kohout LJ, et al. Deprenyl in Parkinson’s disease. Lancet 1977; II: 791–5Google Scholar
  127. 127.
    Hietanen MH. Selegiline and cognitive function in Parkinson’s disease. Acta Neurol Scand 1991; 84: 407–10PubMedGoogle Scholar
  128. 128.
    Indaco A, Carrieri PD. Amitriptyline in the treatment of headache in patients with Parkinson’s disease. Neurology 1988; 38: 1720–2PubMedGoogle Scholar
  129. 129.
    Boer BH, Erdman RAM, Onstenk HJVC, et al. Clomipramine, depresie en de ziekte van Parkinson. Tijdschr Psychiatr 1976; 28: 499–509Google Scholar
  130. 130.
    Laitinen L. Desipramine in treatment of Parkinson’s disease. Acta Neurol Scand 1969; 45: 109–13PubMedGoogle Scholar
  131. 131.
    Bedard P, Parkes JD, Marsden CD. Nomifensine in Parkinson’s disease. Br J Clin Pharmacol 1977; 4Suppl. 2: 187S–90SPubMedGoogle Scholar
  132. 132.
    Andersen J, Aabro E, Gulmann N, et al. Anti-depressive treatment in Parkinson’s disease: a controlled trial of the effect of nortriptyline in patients with Parkinson’s disease treated with L-dopa. Acta Neurol Scand 1980; 62: 210–9PubMedGoogle Scholar
  133. 133.
    Richard IH, Kurlan R, Tanner C, et al. Serotonin syndrome and the combined used of deprenyl and an antidepressant in Parkinson’s disease. Neurology 1997; 48: 1070–7PubMedGoogle Scholar
  134. 134.
    Ritter JL, Alexander B. Retrospective study of selegiline-antidepressant drug interactions and a review of the literature. Ann Clin Psychiatry 1997; 9: 7–13PubMedGoogle Scholar
  135. 135.
    King SA. Pain in depression and Parkinson’s disease [letter]. Am J Psychiatry 1993; 150: 353–4PubMedGoogle Scholar
  136. 136.
    Mayeux R, Williams JB, Stern Y, et al. Depression and Parkinson’s disease. Adv Neurol 1984; 40: 241–50PubMedGoogle Scholar
  137. 137.
    Mann JJ, Aarons SF, Wilner PJ, et al. A controlled study of the antidepressant efficacy and side effects of (−)-deprenyl: a selective monoamine oxidase inhibitor. Arch Gen Psychiatry 1989; 46: 45–50PubMedGoogle Scholar

Copyright information

© Adis International Limited 1998

Authors and Affiliations

  • Tiffany Tom
    • 1
    • 2
  • Jeffrey L. Cummings
    • 1
    • 2
    • 3
  1. 1.Department of NeurologyUCLA School of MedicineLos AngelesUSA
  2. 2.Neuropsychiatry and Neurobehavior Unit, Psychiatry ServiceWest Los Angeles Veterans Affairs Medical CenterLos AngelesUSA
  3. 3.Department of Psychiatry and Biobehavioral SciencesUCLA School of MedicineLos AngelesUSA
  4. 4.Reed Neurological Research CenterUCLA School of MedicineLos AngelesUSA

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