Antidepressants in Parkinson's disease. Recommendations by the movement disorder study group of the Neurological Association of Madrid

ConclusionsEvidence suggests that nortriptyline, venlafaxine, paroxetine, and citalopram may be useful in treating depression in PD, although studies on paroxetine and citalopram yield conflicting results. In clinical practice, however, selective serotonin reuptake inhibitors are usually considered the treatment of choice. Duloxetine may be an alternative to venlafaxine, although the evidence for this is less, and venlafaxine plus mirtazapine may be useful in drug-resistant cases. Furthermore, citalopram may be indicated for the treatment of anxiety, atomoxetine for hypersomnia, trazodone and mirtazapine for insomnia and psychosis, and bupropion for apathy. In general, antidepressants are well tolerated in PD. However, clinicians should consider the anticholinergic effect of tricyclic antidepressants, the impact of serotonin-norepinephrine reuptake inhibitors on blood pressure, the extrapyramidal effects of antidepressants, and any potential interactions between monoamine oxidase B inhibitors and other antidepressants.ResumenIntroducciónEl uso de antidepresivos está muy extendido en la enfermedad de Parkinson (EP), aunque existen pocos estudios de calidad que aclaren su eficacia.DesarrolloLa metodología para esta guía clínica se ha basado en la revisión de la literatura y en la opinión de consenso del grupo de trastornos del movimiento de la AMN, recogida mediante una encuesta.ConclusionesSegún la evidencia científica, nortriptilina, venlafaxina, paroxetina o citalop...

Source: Neurologia - July 10, 2018 Category: Neurology Source Type: research