Depression, Anxiety and Psychosis in Parkinson’s Disease

We discuss the prevalence and treatment of depression, anxiety and psychosis in patients with Parkinson’s Disease.

In this episode:
00:46 Not Just A Movement Disorder
01:51 Contributing Factors to Psychiatric Disorders
04:11 Depression: Prevalence
05:18 Depression: Treatment
07:06 Drug interactions
08:38 Anxiety: Prevalence
09:56 Anxiety: Treatment
11:13 Parkinson’s Disease Psychosis Occurs Late
13:08 Psychosis: Symptoms
14:21 Psychosis: Diagnostic Criteria
15:59 Psychosis: Management
21:22 Key Points
22:23 Credits

Key Points:
- Psychiatric symptoms can occur in Parkinson’s Disease as a reaction to the diagnosis and disability associated. Also, consider biological factors and dopaminergic medications too
- For depression, evidence points towards SSRIs and CBT. Avoid TCAs.
- Antidepressants plus selective MAO-B inhibitors have been used clinically, but practice caution for drug interactions.
- For anxiety, consider CBT. Pharmacologically, anxiety might have a more dopaminergic mechanism in PD patients.
- Unique psychotic symptoms in PD include passage and presence hallucinations. And hallucinations seem to be more common than delusions.
- Clozapine, quetiapine,and pimavanserin can be used in psychosis with PD.

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