Depression and Parkinson's Disease: Biological Therapies

Introduction.Depression occurs in approximately 40% of patients with Parkinson's disease. Parkinson's disease is commonly associated with psychiatric morbidity, which includes depression, anxiety, and dopaminergic psychosis. These compound the patient's predicament. Fortunately, a variety of effective treatments are available.Objective.The purpose of this e-poster is to provide an update of the research regarding depression in Parkinson's disease.Methods.Describe a case report. A 56-year-old man, with previous diagnosis of Parkinson's disease. We used SSRIs, but they was not enough to successful treatment so we decided to use ECT.Results.Our patient failed to respond to medication or develop intolerable medication side effects. Electroconvulsive therapy (ECT) should be considered for this group of patients. Contrary to popular belief, ECT is a widely used and safe treatment for depression when medication fails. ECT has been shown to be effective and safe in PD for treating both depression and dopaminergic psychosis. Several studies also report varying periods of motor improvement following ECT in PD. A study is currently underway at UBC to examine this phenomenon in a controlled setting. ECT improves depression, may permit a reduction in antidepressant medications, and has intrinsic antiparkinsonian properties.Conclusions.ECT, has repeatedly been shown to have beneficial effects in PD, but has never gained acceptance as a clinical treatment option. We review the literature on the use of ECT in PD, pointing out that ECT has beneficial effects on both the core motor symptoms of PD as well as the commonly occurring psychiatric comorbidities.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Deterioration of parkinsonian symptoms following treatment of dopaminergic hallucinosis with olanzapine

SummaryThe atypical antipsychotic drug olanzapine has been proposed for treatment of dopaminergic psychosis in Parkinson's disease (PD). We report on a 68-year-old patient who developed a severe akinetic-rigid extrapyramidal syndrome, accompanied by additional paranoid symptoms, following olanzapine treatment of optic hallucinosis in PD. Olanzapine may also induce clinically relevant extrapyramidal side effects in PD patients.