抑郁和帕金森病  

Depression and Parkinson's disease

作　　者：Lemke M.R. Fuchs G. Gemende I. 夏峰 

机构地区：[1]Rhine Clinic Bonn, Kaiser Karl Ring 20, 53111 Bonn, Germany Dr.

出　　处：《世界核心医学期刊文摘（神经病学分册）》2005年第3期46-46,共1页Digest of the World Core Medical Journals:Clinical Neurology

摘　　要：Depression occurs in approximately 45%of all patients with Parkinsons disea se (PD), reduces quality of life independent of motor symptoms and seems to be u nderrated and undertreated. Characteristics of symptoms differ from major depres sion. Because of overlapping clinical symptoms, diagnosis is based on subjective ly experienced anhedonia and feeling of emptiness. Available rating scales for m ajor depression may not be adequate to correctly measure severity of depression in PD. Anxiety and depression may manifest as first symptoms of PD many years be fore motor symptoms. Serotonergic, noradrenergic and dopaminergic mechanisms pla y key roles in the etiology of depression in PD. Tricyclic and newer, selective antidepressants including serotonin and noradrenaline reuptake inhibitors (SSRI, SNRI) appear to be effective in treating depression in PD. Selective reuptake i nhibitors seem to have a favorable side effect profile. Recent controlled studie s show antidepressant effects of pramipexole in bipolar II depression. New dopam ine agonists pramipexole and ropinirole appear to ameliorate depressive symptoms in PD in addition to effects on motor symptoms. There is a lack of appropriate rating scales and controlled studies regarding depression in PD.Depression occurs in approximately 45%of all patients with Parkinsons disea se (PD), reduces quality of life independent of motor symptoms and seems to be u nderrated and undertreated. Characteristics of symptoms differ from major depres sion. Because of overlapping clinical symptoms, diagnosis is based on subjective ly experienced anhedonia and feeling of emptiness. Available rating scales for m ajor depression may not be adequate to correctly measure severity of depression in PD. Anxiety and depression may manifest as first symptoms of PD many years be fore motor symptoms. Serotonergic, noradrenergic and dopaminergic mechanisms pla y key roles in the etiology of depression in PD. Tricyclic and newer, selective antidepressants including serotonin and noradrenaline reuptake inhibitors (SSRI, SNRI) appear to be effective in treating depression in PD. Selective reuptake i nhibitors seem to have a favorable side effect profile. Recent controlled studie s show antidepressant effects of pramipexole in bipolar II depression. New dopam ine agonists pramipexole and ropinirole appear to ameliorate depressive symptoms in PD in addition to effects on motor symptoms. There is a lack of appropriate rating scales and controlled studies regarding depression in PD.

关 键 词：帕金森病 严重抑郁症 运动症状 普拉克索 多巴胺能 再摄取抑制剂 色胺 抗抑郁药物 激动剂 罗匹尼罗 

分 类 号：R742.5[医药卫生—神经病学与精神病学]