Antidepressants in the treatment of psychosis with comorbid depression in Parkinson disease.
Psychotic symptoms are commonly associated with Parkinson disease and can be a source of significant morbidity. Depression has been reported as a comorbidity in patients with psychosis. We describe a patient with Parkinson disease with psychotic symptoms and comorbid depression whose treatment refractory delusions and hallucinations improved markedly only after antidepressant monotherapy was initiated. The phenomenology of the delusions was atypical for those found in Parkinson or in depression. Psychotic symptoms refractory or only partially responsive to conventional treatment should prompt a search for potential underlying psychiatric comorbidities. Given case reports of exacerbation of psychotic symptoms with antidepressants, we emphasize careful identification and active follow up of the comorbid depressive disorders in PD patients with psychosis. Potential mechanisms implicated in the response of psychosis to antidepressants are discussed.
Voon
Valerie
V
University of Toronto, Toronto Western Hospital University Health Network, Ontario, Canada. valerie.voon@uhn.on.ca
Lang
Anthony E
AE
D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use*; D015897:Comorbidity; D003702:Delusions / Q000188:drug therapy / Q000209:etiology; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D006212:Hallucinations / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000523:psychology*; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000209:etiology; D012720:Severity of Illness Index
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram