title: Pharmacologic treatment of anxiety disorders in Parkinson disease.
abstract: OBJECTIVE
  Neither best practices nor an evidence base for the pharmacologic treatment of anxiety in Parkinson disease (PD) has been established. This study investigated pharmacologic treatment of anxiety disorders in idiopathic PD and the associated clinical features.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Three community-based movement disorder neurology practices.
  
  
  METHODS
  250 subjects with PD.
  
  
  METHODS
  Anxiety disorder diagnoses were established by consensus using a panel of six psychiatrists with expertise in geriatric psychiatry and movement disorders. Current medications were provided by the treating neurologists at the time of interview.
  
  
  RESULTS
  Among subjects with anxiety disorders only, 53% were untreated with medications. When anxious subjects with comorbid depressive disorders were included, 70.8% were on medications effective for treatment of anxiety. Subjects with anxiety and comorbid depressive disorders were more likely to be treated for their psychiatric disturbances than subjects with anxiety disorders alone (odds ratio: 8.33), as were subjects with comorbid motor fluctuations (odds ratio: 3.65). There were no differences in the types of anti-anxiety medications used in regard to the presence of depression or motor fluctuations.
  
  
  CONCLUSIONS
  These findings suggest that over half of nondepressed PD patients with clinically significant anxiety are untreated with medication. A better understanding of the role of clinical features associated with anxiety in PD, such as depression and motor fluctuations, may improve the recognition and treatment of anxiety disorders in this population.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: gponton1@jhmi.edu.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Pontone
authors.forename: James R
authors.initials: JR
authors.lastname: Williams
authors.forename: Karen E
authors.initials: KE
authors.lastname: Anderson
authors.forename: Gary
authors.initials: G
authors.lastname: Chase
authors.forename: Susanne R
authors.initials: SR
authors.lastname: Goldstein
authors.forename: Stephen
authors.initials: S
authors.lastname: Grill
authors.forename: Elaina S
authors.initials: ES
authors.lastname: Hirsch
authors.forename: Susan
authors.initials: S
authors.lastname: Lehmann
authors.forename: John T
authors.initials: JT
authors.lastname: Little
authors.forename: Russell L
authors.initials: RL
authors.lastname: Margolis
authors.forename: Justin
authors.initials: J
authors.lastname: Palanci
authors.forename: Peter V
authors.initials: PV
authors.lastname: Rabins
authors.forename: Howard D
authors.initials: HD
authors.lastname: Weiss
authors.forename: Laura
authors.initials: L
authors.lastname: Marsh
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000150:complications* / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'