title: Antidepressants in Parkinson's disease. Recommendations by the movement disorder study group of the Neurological Association of Madrid.
abstract: BACKGROUND
  Although antidepressants are widely used in Parkinson's disease (PD), few well-designed studies to support their efficacy have been conducted.
  
  
  METHODS
  These clinical guidelines are based on a review of the literature and the results of an AMN movement disorder study group survey.
  
  
  CONCLUSIONS
  Evidence suggests that nortriptyline, venlafaxine, paroxetine, and citalopram may be useful in treating depression in PD, although studies on paroxetine and citalopram yield conflicting results. In clinical practice, however, selective serotonin reuptake inhibitors are usually considered the treatment of choice. Duloxetine may be an alternative to venlafaxine, although the evidence for this is less, and venlafaxine plus mirtazapine may be useful in drug-resistant cases. Furthermore, citalopram may be indicated for the treatment of anxiety, atomoxetine for hypersomnia, trazodone and mirtazapine for insomnia and psychosis, and bupropion for apathy. In general, antidepressants are well tolerated in PD. However, clinicians should consider the anticholinergic effect of tricyclic antidepressants, the impact of serotonin-norepinephrine reuptake inhibitors on blood pressure, the extrapyramidal effects of antidepressants, and any potential interactions between monoamine oxidase B inhibitors and other antidepressants.
authors.affiliation: Servicio de Neurología, Hospital Sanitas La Moraleja, Madrid, España. Electronic address: epenal.pex@sanitas.es.
authors.forename: E
authors.initials: E
authors.lastname: Peña
authors.affiliation: Servicio de Neurología, Hospital Infanta Sofía, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Mata
authors.affiliation: Servicio de Neurología, Hospital de La Princesa, Madrid, España.
authors.forename: L
authors.initials: L
authors.lastname: López-Manzanares
authors.affiliation: Servicio de Neurología, Hospital Ruber Internacional, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Kurtis
authors.affiliation: Servicio de Neurología, Hospital de Torrejón, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Eimil
authors.affiliation: Servicio de Neurología, Hospital Ramón y Cajal, Madrid, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Martínez-Castrillo
authors.affiliation: Servicio de Neurología, Hospital Fundación Jiménez Díaz, Madrid, España.
authors.forename: I
authors.initials: I
authors.lastname: Navas
authors.affiliation: Servicio de Neurología, Hospital 12 de Octubre, Madrid, España.
authors.forename: I J
authors.initials: IJ
authors.lastname: Posada
authors.affiliation: Servicio de Neurología, Hospitales Rey Juan Carlos, Infanta Elena y Villalba, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Prieto
authors.affiliation: Servicio de Neurología, Clínica del Rosario, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Ruíz-Huete
authors.affiliation: Servicio de Neurología, Hospital Fundación Alcorcón, Madrid, España.
authors.forename: L
authors.initials: L
authors.lastname: Vela
authors.affiliation: Servicio de Neurología, Hospitales Rey Juan Carlos, Infanta Elena y Villalba, Madrid, España.
authors.forename: B
authors.initials: B
authors.lastname: Venegas
keywords: Ansiedad; Antidepresivos; Antidepressants; Anxiety; Depresión; Depression; Efectos secundarios; Enfermedad de Parkinson; Mecanismos de acción; Mechanisms of action; Parkinson's disease; Side effects