Prevalence, impact, and management of depression and anxiety in patients with Parkinson’s disease

Figures & data

Table 1 Summary (with literature-based references) of prevalence, risk factors, etiological considerations, and evidence-based treatments for depression and anxiety in Parkinson’s disease

Depression	Anxiety
Prevalence
~40%^Citation25,Citation27	~40%^Citation1,Citation85–Citation87
Risk factors
Akinetic rigid/PIGD motor subtype^Citation25,Citation34–Citation36	Motor fluctuations^Citation5,Citation85,Citation92,Citation93,Citation104 Younger onset^Citation87,Citation104
Motor fluctuations^Citation39,Citation104
Younger disease onset^Citation38,Citation39,Citation41
Right-sided motor asymmetry^Citation41–Citation43
Female sex^Citation45
History of premorbid depression^Citation45
Family history of depression^Citation45
Worse disability/poor cognition^Citation45
Neurobiological components
Mesolimbic dopaminergic^Citation51 dysfunction	Disinhibition/dysfunction of amygdala^Citation87
Mesocortical dopaminergic dysfunction	Disinhibition/dysfunction of locus coeruleus^Citation87,Citation97
Serotonergic dysfunction^Citation47	Dysfunction of raphe nucleus^Citation87
Neuroinflammation^Citation52,Citation53	Abnormalities in norepinephrine, serotonin, dopamine, and γ-aminobutyric acid (GABA) neurotransmitters^Citation4,Citation87
Psychosocial components
Adjustment to chronic illness/disability	Adjustment to chronic illness/ disability^Citation87,Citation95
	Social shame^Citation95
	Motor fluctuations^Citation85
	Fear of falling^Citation25
Pharmacologic treatments
SSRI^Citation59,Citation60	SSRI^Citation56,Citation60
SNRI^Citation54,Citation59	TCA^Citation56,Citation60
TCA^Citation59,Citation60	Atomoxetine^Citation101
Pramipexole^Citation65
Nonpharmacological treatments
CBT^Citation19,Citation20	CBT^Citation19,Citation20
Omega-III^Citation20,Citation83	ECT^Citation103
rTMS^Citation59,Citation72,Citation80
ECT^Citation82–Citation84

Abbreviations: PIGD, postural instability/gait disorder; SSRI, selective serotonin reuptake inhibitor; SNRI, serotonin-norepinephrine reuptake inhibitor; TCA, tricyclic antidepressant; CBT, cognitive behavioral therapy; rTMS, repetitive transcranial magnetic stimulation; ECT, electroconvulsive therapy.

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