Depression Can Be a Forgotten Parkinson’s Symptom

Depression is the most common non-motor symptom of Parkinson’s disease, but a new study from Northwestern University suggests that this symptom is rarely treated in Parkinson’s patients. The study was published in July 2014 in the Journal of Parkinson’s Disease.  The study looked at the records of more than 7,000 patients in the National Parkinson’s Foundation (NPS). The researchers found symptoms of depression in nearly one-quarter of the patients. However, they also found that only one-third of those with serious depression symptoms had been prescribed antidepressants, and even fewer had received counseling for their symptoms. Over the course of the next year, the researchers kept tabs on the remaining two-thirds of the patients who showed high levels of depression symptoms. Throughout that year, only an additional 10 percent of patients were prescribed medication to treat their depression or referred for counseling.

Parkinson’s a Chronis, Often Debilitating Illness

Parkinson’s disease is a chronic, progressive disorder that affects the nervous system. The motor symptoms of Parkinson’s are the features most commonly associated with this disease, especially the tremor that often first appears in a hand or fingers. In addition to tremors, slowed movement and muscle rigidity are common as the illness progresses. Various complications can appear with Parkinson’s, the most common being sleep problems, trouble swallowing, constipation and bladder problems. In the later stages of the illness, dementia and difficulty thinking are more likely to develop. There is no known cure for Parkinson’s disease, but medication can significantly alleviate symptoms during the earlier stages of the illness. Unfortunately, the cognitive difficulties that can be seen in the later stages are not responsive to current medications.

Depression Reduces Quality of Life

With the often-debilitating progress of this serious illness, it is not entirely surprising that symptoms of depression often become overshadowed and ignored. However, the authors of the Northwestern study believe that this fact is worrying because “previous research has determined that depression is a major determinant of overall quality of life” in patients with Parkinson’s disease. It is likely that depression in many patients with Parkinson’s is a result of the challenges of living with this illness rather than a direct result of the degeneration or death of nerve cells in the brain. However, the fact that these symptoms contributed to the rise of the disease does not always mean that alleviating the symptoms will also help the depression. Even when depression is triggered by a particular situation, it often takes distinct medication and counseling to treat the symptoms. The researchers for this new study also reported that while the number of patients being treated for depressive symptoms was low, recognition of depressive symptoms was surprisingly high. This was somewhat encouraging, since symptoms of depression can often go entirely unnoticed in patients who are dealing with the more serious physical and cognitive degeneration that can be found in the later stages of Parkinson’s disease. However, they also pointed out that the patients for this study had all visited treatment sites that have been designated “centers of excellence” by the NPF. At sites like these where the quality of care is exceptionally high, depression symptoms may be more commonly recognized than in other locations. This means that nationwide recognition of depression in Parkinson’s patients may actually be lower than this study suggests.   Dr. Danny Bega, lead author of the study, says the results show that physicians should be better about screening Parkinson’s patients for depression, and also more proactive about referring them for treatment. He also believes that research is needed to determine how effective standard approaches to treating depression are when it comes to caring for Parkinson’s patients.

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