Cummings J L, Masterman D L
UCLA Medical Centre, California, USA.
Int J Geriatr Psychiatry. 1999 Sep;14(9):711-8.
Parkinson's disease (PD) is a disabling neurodegenerative condition commonly complicated by the existence of comorbid depression. The prevalence rates of depression in this patient group have been reported to be as high as 40%. Currently, depression in PD is undertreated; there have been few controlled clinical trials of antidepressants in this patient group. Patients with PD are usually elderly and often administered a range of medication, therefore the choice of antidepressant must be undertaken with care. Tricyclic antidepressants (TCAs) have been studied in patients with PD and comorbid depression; however, the risk of anticholinergic side-effects means that their use is largely avoided. Selective serotonin reuptake inhibitors have comparable efficacy to the TCAs and a better tolerability profile in patients with depression; they are rapidly being considered as first-line therapy for PD patients with depression. Clinical studies in this patient group are warranted. This article reviews the characteristics of comorbid depression in patients with PD and discusses the treatment options available.
帕金森病（PD）是一种致残性神经退行性疾病，常并发抑郁症。据报道，该患者群体中抑郁症的患病率高达40%。目前，PD患者的抑郁症治疗不足；针对该患者群体使用抗抑郁药的对照临床试验很少。PD患者通常为老年人，且常服用多种药物，因此选择抗抑郁药时必须谨慎。三环类抗抑郁药（TCA）已在PD合并抑郁症患者中进行了研究；然而，抗胆碱能副作用的风险意味着在很大程度上应避免使用它们。选择性5-羟色胺再摄取抑制剂在抑郁症患者中的疗效与TCA相当，耐受性更好；它们正迅速被视为PD合并抑郁症患者的一线治疗药物。有必要对该患者群体进行临床研究。本文综述了PD患者合并抑郁症的特点，并讨论了可用的治疗选择。
