Chen Jack J, Marsh Laura
Schools of Medicine and Pharmacy, Loma Linda University, Loma Linda, California.
Pharmacotherapy. 2013 Sep;33(9):972-83. doi: 10.1002/phar.1314. Epub 2013 Jun 24.
Depression is a common psychiatric comorbidity in Parkinson's disease (PD) and contributes to significant impairments in cognitive, functional, motor, and social performance. This results in reduced quality of life, higher levels of care dependency, and increased caregiver burden. When treating depression, it is important to ensure that the patient's response to treatment will be adequately monitored. This can be accomplished in neurology or primary care settings, or in clinical settings with interdisciplinary treatment teams. Mental health services should be engaged early as a component of ongoing comprehensive care. This article reviews a general approach to treating the pharmacotherapy of depression in PD. Ultimately, clinicians should rely on empiric assessments of known risks and putative benefits to guide treatment decisions and should include a targeted and individualized multimodal approach that utilizes psychotherapeutic interventions along with pharmacologic therapies.
抑郁症是帕金森病（PD）常见的精神共病，会导致认知、功能、运动和社交表现出现显著损害。这会导致生活质量下降、护理依赖程度增加以及照顾者负担加重。在治疗抑郁症时，确保对患者的治疗反应进行充分监测非常重要。这可以在神经科或初级保健机构中完成，也可以在有跨学科治疗团队的临床环境中进行。心理健康服务应尽早作为持续综合护理的一部分加以利用。本文综述了治疗帕金森病抑郁症药物治疗的一般方法。最终，临床医生应依靠对已知风险和假定益处的经验性评估来指导治疗决策，并应采用一种有针对性的个体化多模式方法，该方法将心理治疗干预与药物治疗相结合。
