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DOI: 10.1055/s-0038-1626291
Parkinson-Syndrom und Depression
Parkinson’s disease and depressionPublikationsverlauf
Publikationsdatum:
19. Januar 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.
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