Nervenheilkunde 2004; 23(03): 143-150
DOI: 10.1055/s-0038-1626291
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Parkinson-Syndrom und Depression

Parkinson’s disease and depression
A. O. Ceballos-Baumann
1   Neurologische Klinik, Klinikum rechts der Isar, Technische Universität München
,
M. R. Lemke
2   Rheinische Kliniken Bonn
› Author Affiliations
Further Information

Publication History

Publication Date:
19 January 2018 (online)

Zusammenfassung

Depression hat einen wesentlichen Einfluss auf die gemessene Lebensqualität von Parkinson-Patienten, obwohl nur ca. 2% der Patienten und 1% der Angehörigen sich einer Depression bewusst sind. Zwischen der Depression und motorischer Beeinträchtigung besteht kein linearer Zusammenhang, was pathogenetisch auf eine krankheitsimmanente Ursache hinweist, am ehesten bedingt durch das Defizit von Dopamin und anderen monaminergen Neurotransmittern. Depressionen treten bei ca. 40-50% der Parkinson-Patienten auf und werden nicht immer adäquat versorgt. Zur Therapie mit Antidepressiva finden sich nur wenige kontrollierte Studien. Als wirksam haben sich trizyklische Antidepressiva und neuere Antidepressiva wie selektive Serotonin-und Noradrenalin-Wiederaufnahmehemmer gezeigt, die ein für ältere Patienten günstigeres Profil unerwünschter Wirkungen haben. Auch neuere Dopaminagonisten könnten eine therapeutische Wirkung auf depressive Symptome haben.

Summary

Depression has a great impact on measured quality of life in Parkinson’s disease patients, although only 2% of the patients and 1% of the relatives are aware of a depression. There is no linear relation between motor impairment and depression, which suggests a disease immanent cause, most likely linked to the deficit of dopamine and other monoaminergic neurotransmitters. Depression occurs in approximately 40-50% of the patients and may worsen functional impairment. But depression in Parkinson´s disease is under-diagnosed, under-treated and under-researched. There are only few controlled studies about antidepressants in depressed Parkinson patients. Tricyclics and selective serotonin-and norepinephrine reuptake inhibitors appear to ameliorate depressive symptoms in Parkinson’s disease. Selective reuptake inhibitors seem to present with a more favourable profile of adverse effects.

 
  • Literatur

  • 1 A randomized controlled trial of amantadine in fatigue associated with multiple sclerosis. The Canadian MS Research Group. Can J Neurol Sci 1987; 14 (03) 273-8.
  • 2 Pramipexole vs levodopa as initial treatment for Parkinson disease: A randomized controlled trial. Parkinson Study Group. JAMA 2000; 284 (15) 1931-8.
  • 3 Dopamine transporter brain imaging to assess the effects of pramipexole vs levodopa on Parkinson disease progression. Parkinson Study Group. JAMA 2002; 287 (13) 1653-61.
  • 4 Factors impacting on quality of life in Parkinson’s disease: results from an international survey. Global Parkinson’s Disease Survey Steering Committee. Mov Disord 2002; 17 (01) 60-7.
  • 5 Treatment of depression in idiopathic Parkinson’s disease. Mov Disord. 2002; 17 (Suppl. 04) S112-9.
  • 6 Psychosocial counseling in Parkinson’s disease. Mov Disord. 2002; 17 (Suppl. 04) S160-2.
  • 7 Aarsland D, Larsen JP, Lim NG, Janvin C, Karlsen K, Tandberg E, Cummings JL. Range of neuropsychiatric disturbances in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 1999; 67 (04) 492-6.
  • 8 Andersen J, Aabro E, Gulmann N, Hjelmsted A, Pedersen HE. 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 (04) 210-9.
  • 9 Bader JP, Hell D. (Parkinson syndrome and depression). Fortschr Neurol Psychiatr 1998; 66 (07) 303-12.
  • 10 Barclay CL, Duff J, Sandor P, Lang AE. Limited usefulness of electroconvulsive therapy in progressive supranuclear palsy. Neurology 1996; 46 (05) 1284-6.
  • 11 Bejjani BP, Damier P, Arnulf I, Thivard L, Bonnet AM, Dormont D, Cornu P, Pidoux B, Samson Y, Agid Y. Transient acute depression induced by high-frequency deep-brain stimulation. N Engl J Med 1999; 340 (19) 1476-80.
  • 12 Berney A, Vingerhoets F, Perrin A, Guex P, Villemure JG, Burkhard PR, Benkelfat C, Ghika J. Effect on mood of subthalamic DBS for Parkinson’s disease: a consecutive series of 24 patients. Neurology 2002; 59 (09) 1427-9.
  • 13 Black KJ, Hershey T, Koller JM, Videen TO, Mintun MA, Price JL, Perlmutter JS. A possible substrate for dopamine-related changes in mood and behavior: prefrontal and limbic effects of a D3-preferring dopamine agonist. Proc Natl Acad Sci USA 2002; 99 (26) 17113-8.
  • 14 Brown RG, MacCarthy B, Gotham AM, Der GJ, Marsden CD. Depression and disability in Parkinson’s disease: a follow-up of 132 cases. Psychol Med 1988; 18 (01) 49-55.
  • 15 Ceballos-Baumann AO, Boecker H, Bartenstein P, von Falkenhayn I, Riescher H, Conrad B, Moringlane JR, Pinter M, Alesch F. A PET study of subthalamic nucleus stimulation in Parkinson´s disease: Enhanced movement related activity of motor association cortex and decreased motor cortex resting activity. Arch Neurol. 1999: 997-1003.
  • 16 Ceravolo R, Nuti A, Piccinni A, Dell’Agnello G, Bellini GGambaccini, Dell’Osso L, Murri L, Bonuccelli U. Paroxetine in Parkinson’s disease: effects on motor and depressive symptoms. Neurology 2000; 55 (08) 1216-8.
  • 17 Ceravolo R, Piccini P, Bailey DL, Jorga KM, Bryson H, Brooks DJ. 18F-dopa PET evidence that tolcapone acts as a central COMT inhibitor in Parkinson’s disease. Synapse 2002; 43 (03) 201-7.
  • 18 Corrigan MH, Denahan AQ, Wright CE, Ragual RJ, Evans DL. Comparison of pramipexole, fluoxetine, and placebo in patients with major depression. Depress Anxiety 2000; 11 (02) 58-65.
  • 19 Dingemanse J. Issues important for rational COMT inhibition. Neurology 2000; 55 (11 Suppl 4): S24-7 discussion S28-32.
  • 20 Doshi PK, Chhaya N, Bhatt MH. Depression leading to attempted suicide after bilateral subthalamic nucleus stimulation for Parkinson’s disease. Mov Disord 2002; 17 (05) 1084-5.
  • 21 Ellgring H, Seiler S, Perleth B, Frings W, Gasser T, Oertel W. Psychosocial aspects of Parkinson’s disease. Neurology 1993; 43 (12 Suppl 6): S41-4.
  • 22 Factor SA, Molho ES, Feustel PJ, Brown DL, Evans SM. Long-term comparative experience with tolcapone and entacapone in advanced Parkinson’s disease. Clin Neuropharmacol 2001; 24 (05) 295-9.
  • 23 Fahn S, Chouinard S. Experience with tranylcypromine in early Parkinson’s disease. J Neural Transm Suppl 1998; 52: 49-61.
  • 24 Fava M, Rosenbaum JF, Kolsky AR, Alpert JE, Nierenberg AA, Spillmann M, Moore C, Renshaw P, Bottiglieri T, Moroz G, Magni G. Open study of the catechol-O-methyltransferase inhibitor tolcapone in major depressive disorder. J Clin Psychopharmacol 1999; 19 (04) 329-35.
  • 25 Fetoni V, Soliveri P, Monza D, Testa D, Girotti F. Affective symptoms in multiple system atrophy and Parkinson’s disease: response to levodopa therapy. J Neurol Neurosurg Psychiatry 1999; 66 (04) 541-4.
  • 26 Funkiewiez A, Ardouin C, Krack P, Fraix V, van Blercom N, Xie J, Moro E, Benabid AL, Pollak P. Acute psychotropic effects of bilateral subthalamic nucleus stimulation and levodopa in Parkinson’s disease. Mov Disord 2003; 18 (05) 524-30.
  • 27 Goetz CG, Tanner CM, Klawans HL. Bupropion in Parkinson’s disease. Neurology 1984; 34 (08) 1092-4.
  • 28 Greenberg R, Meyers BS. Treatment of major depression and Parkinson’s disease with combined phenelzine and amantadine. Am J Psychiatry 1985; 142 (02) 273-4.
  • 29 Greeson JM, Sanford B, Monti DA. St. John’s wort (Hypericum perforatum): a review of the current pharmacological, toxicological, and clinical literature. Psychopharmacology (Berl) 2001; 153 (04) 402-14.
  • 30 Groenewegen HJ, Berendse HW. Connections of the subthalamic nucleus with ventral striatopallidal parts of the basal ganglia in the rat. J Comp Neurol 1990; 294 (04) 607-22.
  • 31 Hauser RA, Zesiewicz TA. Sertraline for the treatment of depression in Parkinson’s disease. Mov Disord 1997; 12 (05) 756-9.
  • 32 Hietanen MH. Selegiline and cognitive function in Parkinson’s disease. Acta Neurol Scand 1991; 84 (05) 407-10.
  • 33 Hogl B, Peralta C, Wetter TC, Gershanik O, Trenkwalder C. Effect of sleep deprivation on motor performance in patients with Parkinson’s disease. Mov Disord 2001; 16 (04) 616-21.
  • 34 Hogl BE, Gomez-Arevalo G, Garcia S, Scipioni O, Rubio M, Blanco M, Gershanik OS. A clinical, pharmacologic, and polysomnographic study of sleep benefit in Parkinson’s disease. Neurology 1998; 50 (05) 1332-9.
  • 35 Hooten WM, Melin G, Richardson JW. Response of the Parkinsonian symptoms of multiple system atrophy to ECT. Am J Psychiatry 1998; 155 (11) 1628.
  • 36 Houeto JL, Mesnage V, Mallet L, Pillon B, Gargiulo M, du Moncel ST, Bonnet AM, Pidoux B, Dormont D, Cornu P, Agid Y. Behavioural disorders, Parkinson’s disease and subthalamic stimulation. J Neurol Neurosurg Psychiatry 2002; 72 (06) 701-7.
  • 37 Huber TJ, Dietrich DE, Emrich HM. Possible use of amantadine in depression. Pharmacopsychiatry 1999; 32 (02) 47-55.
  • 38 Kasper S, Moises HW, Beckmann H. The anticholinergic biperiden in depressive disorders. Pharmacopsychiatria 1981; 14 (06) 195-8.
  • 39 Krack P, Kumar R, Ardouin C, Dowsey PL, McVicker JM, Benabid AL, Pollak P. Mirthful laughter induced by subthalamic nucleus stimulation. Mov Disord 2001; 16 (05) 867-75.
  • 40 Krupp LB, Coyle PK, Doscher C, Miller A, Cross AH, Jandorf L, Halper J, Johnson B, Morgante L, Grimson R. Fatigue therapy in multiple sclerosis: results of a double-blind, randomized, parallel trial of amantadine, pemoline, and placebo. Neurology 1995; 45 (11) 1956-61.
  • 41 Kulisevsky J, Berthier ML, Gironell A, Pascual-Sedano B, Molet J, Pares P. Mania following deep brain stimulation for Parkinson’s disease. Neurology 2002; 59 (09) 1421-4.
  • 42 Kumar R, Krack P, Pollak P. Transient acute depression induced by high-frequency deep-brain stimulation. N Engl J Med 1999; 341 (13) 1003-4.
  • 43 Kuopio AM, Marttila RJ, Helenius H, Toivonen M, Rinne UK. The quality of life in Parkinson’s disease. Mov Disord 2000; 15 (02) 216-23.
  • 44 Leentjens AF, van den Akker M, Metsemakers JF, Lousberg R, Verhey FR. Higher incidence of depression preceding the onset of Parkinson’s disease: a register study. Mov Disord 2003; 18 (04) 414-8.
  • 45 Lees AJ, Shaw KM, Kohout LJ, Stern GM, Elsworth JD, Sandler M, Youdim MB. Deprenyl in Parkinson’s disease. Lancet 1977; 02 8042 791-5.
  • 46 Lemke MR. Effect of reboxetine on depression in Parkinson’s disease patients. J Clin Psychiatry 2002; 63 (04) 300-4.
  • 47 Leo RJ. Movement disorders associated with the serotonin selective reuptake inhibitors. J Clin Psychiatry 1996; 57 (10) 449-54.
  • 48 Lou JS, Kearns G, Oken B, Sexton G, Nutt J. Exacerbated physical fatigue and mental fatigue in Parkinson’s disease. Mov Disord 2001; 16 (02) 190-6.
  • 49 Mann JJ, Aarons SF, Wilner PJ, Keilp JG, Sweeney JA, Pearlstein T, Frances AJ, Kocsis JH, Brown RP. A controlled study of the antidepressant efficacy and side effects of (-)-deprenyl. A selective monoamine oxidase inhibitor. Arch Gen Psychiatry 1989; 46 (01) 45-50.
  • 50 Maricle RA, Nutt JG, Carter JH. Mood and anxiety fluctuation in Parkinson’s disease associated with levodopa infusion: preliminary findings. Mov Disord 1995; 10 (03) 329-32.
  • 51 Mattox JH, Buckman MT, Bernstein J, Pathak D, Kellner R. Dopamine agonists for reducing depression associated with hyperprolactinemia. J Reprod Med 1986; 31 (08) 694-8.
  • 52 Maurice N, Deniau JM, Menetrey A, Glowinski J, Thierry AM. Prefrontal cortex-basal ganglia circuits in the rat: involvement of ventral pallidum and subthalamic nucleus. Synapse 1998; 29 (04) 363-70.
  • 53 Mayberg HS, Starkstein SE, Sadzot B, Preziosi T, Andrezejewski PL, Dannals RF, Wagner HN, Robinson RG. Selective hypometabolism in the inferior frontal lobe in depressed patients with Parkinson’s disease. Ann Neurol 1990; 28 (01) 57-64.
  • 54 Menza MA, Sage J, Marshall E, Cody R, Duvoisin R. Mood changes and »on-off« phenomena in Parkinson’s disease. Mov Disord 1990; 05 (02) 148-51.
  • 55 Metman LV, Del Dotto P, LePoole K, Konitsiotis S, Fang J, Chase TN. Amantadine for levodopa-induced dyskinesias: a 1-year follow-up study. Arch Neurol 1999; 56 (11) 1383-6.
  • 56 Moellentine C, Rummans T, Ahlskog JE, Harmsen WS, Suman VJ, O’Connor MK, Black JL, Pileggi T. Effectiveness of ECT in patients with parkinsonism. J Neuropsychiatry Clin Neurosci 1998; 10 (02) 187-93.
  • 57 Moreau JJ, Borgulya JJ, Jenck FF, Martin JJ. Tolcapone: a potential new antidepressant detected in a novel animal model of depression. Behav Pharmacol 1994; 05 (03) 344-50.
  • 58 Moryl E, Danysz W, Quack G. Potential antidepressive properties of amantadine, memantine and bifemelane. Pharmacol Toxicol 1993; 72 (06) 394-7.
  • 59 Obeso JA, Guridi J, Delong M. Surgery for parkinsons disease. Journal Of Neurology Neurosurgery And Psychiatry Jan 1997; 62 (01) 2-8.
  • 60 Okun MS, Watts RL. Depression associated with Parkinson’s disease: clinical features and treatment. Neurology 2002; 58 (4 Suppl 1): S63-70.
  • 61 Pahwa R, Lyons KE. Mirtazapine in essential tremor: a double-blind, placebo-controlled pilot study. Mov Disord 2003; 18 (05) 584-7.
  • 62 Parkinson J. An essay on the shaking palsy. London; Sherwood, Neely an Jones; 1817
  • 63 Pridmore S, Yeo PT, Pasha MI. Electroconvulsive therapy for the physical signs of Parkinson’s disease without depressive disorder. J Neurol Neurosurg Psychiatry 1995; 58 (05) 641-2.
  • 64 Pridmore S, Pollard C. Electroconvulsive therapy in Parkinson’s disease: 30 month follow up. J Neurol Neurosurg Psychiatry 1996; 60 (06) 693.
  • 65 Quinn NP. Classification of fluctuations in patients with Parkinson’s disease. Neurology 1998; 51 (2 Suppl 2): S25-9.
  • 66 Rascol O, Brooks DJ, Korczyn AD, De Deyn PP, Clarke CE, Lang AE. A five-year study of the incidence of dyskinesia in patients with early Parkinson’s disease who were treated with ropinirole or levodopa. 056 Study Group. N Engl J Med 2000; 342 (20) 1484-91.
  • 67 Rektorova I, Rektor I, Bares M, Dostal V, Ehler E, Fanfrdlova Z, Fiedler J, Klajblova H, Kulist’ak P, Ressner P, Svatova J, Urbanek K, Veliskova J. Pramipexole and pergolide in the treatment of depression in Parkinson’s disease: a national multicentre prospective randomized study. Eur J Neurol 2003; 10 (04) 399-406.
  • 68 Richard IH, Maughn A, Kurlan R. Do serotonin reuptake inhibitor antidepressants worsen Parkinson’s disease? A retrospective case series. Mov Disord 1999; 14 (01) 155-7.
  • 69 Richard IH. Depression in Parkinson’s Disease. Curr Treat Options Neurol 2000; 02 (03) 263-74.
  • 70 Rinne UK, Bracco F, Chouza C, Dupont E, Gershanik O, Masso J, Montastruc JL, Marsden CD, Dubini A, Orlando N, Grimaldi R, Bergamasco B, Mamoli A, Scarpa M, Scarano M, Canal N, Franceschi M, Albanese A, Bentivoglio AR, Barone P, Cicarelli G, Malesani R, Micheli F, Muchnik S, Pliego L, Somoza M, Gori HE, Dominguez R, Famulari A, Aljanati R, Mikkelsen B, Olive JM, Burguera J, Miquel F, Gimenezroldan S, Mateo D, Allain H, Verin M, Degos JD, Destee A, Warter JM, Bernardi F, Chillotti C, Serra JP, Garriga MC, Benecke R, Pirotta R, Grossoni M. Cabergoline in the treatment of early parkinsons disease: results of the first year of treatment in a double blind comparison of cabergoline and levodopa. Neurology 1997; 48 (02) 363-8.
  • 71 Saint-Cyr JA, Trepanier LL, Kumar R, Lozano AM, Lang AE. Neuropsychological consequences of chronic bilateral stimulation of the subthalamic nucleus in Parkinson’s disease. Brain 2000; 123 (Pt 10): 2091-108.
  • 72 Schrag A, Jahanshahi M, Quinn N. What contributes to quality of life in patients with Parkinson’s disease?. J Neurol Neurosurg Psychiatry 2000; 69 (03) 308-12.
  • 73 Schroeder U, Kuehler A, Haslinger B, Erhard P, Fogel W, Tronnier VM, Lange KW, Boecker H, Ceballos-Baumann AO. Subthalamic nucleus stimulation affects striato-anterior cingulate cortex circuit in a response conflict task: a PET study. Brain 2002; 125 (Pt 9): 1995-2004.
  • 74 Schroeder U, Kuehler A, Lange KW, Haslinger B, Tronnier VM, Krause M, Pfister R, Boecker H, Ceballos-Baumann AO. Subthalamic nucleus stimulation affects a frontotemporal network: a PET study. Ann Neurol 2003; 54 (04) 445-50.
  • 75 Schuurman AG, van den Akker M, Ensinck KT, Metsemakers JF, Knottnerus JA, Leentjens AF, Buntinx F. Increased risk of Parkinson’s disease after depression: a retrospective cohort study. Neurology 2002; 58 (10) 1501-4.
  • 76 Shabnam GN, Th C, Kho D, H R, Ce C. Therapies for depression in Parkinson’s disease. Cochrane Database Syst Rev 2003; 03: CD003465.
  • 77 Shaw KM, Lees AJ, Stern GM. The impact of treatment with levodopa on Parkinson’s disease. Q J Med 1980; 49 (195) 283-93.
  • 78 Starkstein SE, Petracca G, Chemerinski E, Teson A, Sabe L, Merello M, Leiguarda R. Depression in classic versus akinetic-rigid Parkinson’s disease. Mov Disord 1998; 13 (01) 29-33.
  • 79 Stenager EN, Wermuth L, Stenager E, Boldsen J. Suicide in patients with Parkinson’s disease. An epidemiological study. Acta Psychiatr Scand 1994; 90 (01) 70-2.
  • 80 Stern Y, Marder K, Tang MX, Mayeux R. Antecedent clinical features associated with dementia in Parkinson’s disease. Neurology 1993; 43 (09) 1690-2.
  • 81 Sternic N, Kacar A, Filipovic S, Svetel M, Kostic VS. The therapeutic effect of moclobemide, a reversible selective monoamine oxidase A inhibitor, in Parkinson’s disease. Clin Neuropharmacol 1998; 21 (02) 93-6.
  • 82 Steur EN. Increase of Parkinson disability after fluoxetine medication. Neurology 1993; 43 (01) 211-3.
  • 83 Tandberg E, Larsen JP, Aarsland D, Cummings JL. The occurrence of depression in Parkinson’s disease. A community-based study. Arch Neurol 1996; 53 (02) 175-9.
  • 84 Tesei S, Antonini A, Canesi M, Zecchinelli A, Mariani CB, Pezzoli G. Tolerability of paroxetine in Parkinson’s disease: a prospective study. Mov Disord 2000; 15 (05) 986-9.
  • 85 Vale S, Espejel MA, Dominguez JC. Amantadine in depression. Lancet 1971; 02 7721 437.
  • 86 Van der Wurff FB, Stek ML, Hoogendijk WL, Beekman AT. Electroconvulsive therapy for the depressed elderly. Cochrane Database Syst Rev 2003; 02: CD003593.
  • 87 Van Spaendonck KP, Berger HJ, Horstink MW, Buytenhuijs EL, Cools AR. Impaired cognitive shifting in parkinsonian patients on anticholinergic therapy. Neuropsychologia 1993; 31 (04) 407-11.