| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the University of Toronto (J.M.M.), Canada; Rush University Medical Center (K.S.), Chicago, IL; NIH (V.V.), Bethesda, MD; University of Rochester (B.R.), NY; University of Pennsylvania (G.K.-F.), Philadelphia; University of Maryland (K.A., L.M.S., W.J.W.), Baltimore; and University of Kansas (G.G.), Kansas City.
Address correspondence and reprint requests to the American Academy of Neurology, 1080 Montreal Avenue, St. Paul, MN 55116.
Objective: To make evidence-based treatment recommendations for patients with Parkinson disease (PD) with dementia, depression, and psychosis based on these questions: 1) What tools are effective to screen for depression, psychosis, and dementia in PD? 2) What are effective treatments for depression and psychosis in PD? 3) What are effective treatments for PD dementia or dementia with Lewy bodies (DLB)?
Methods: A nine-member multispecialty committee evaluated available evidence from a structured literature review using MEDLINE, and the Cochrane Database of Health and Psychosocial Instruments from 1966 to 2004. Additional articles were identified by panel members.
Results: The Beck Depression Inventory-I, Hamilton Depression Rating Scale, and Montgomery Asberg Depression Rating Scale should be considered to screen for depression in PD (Level B). The Mini-Mental State Examination and the Cambridge Cognitive Examination should be considered to screen for dementia in PD (Level B). Amitriptyline may be considered to treat depression in PD without dementia (Level C). For psychosis in PD, clozapine should be considered (Level B), quetiapine may be considered (Level C), but olanzapine should not be considered (Level B). Donepezil or rivastigmine should be considered for dementia in PD (Level B) and rivastigmine should be considered for DLB (Level B).
Conclusions: Screening tools are available for depression and dementia in patients with PD, but more specific validated tools are needed. There are no widely used, validated tools for psychosis screening in Parkinson disease (PD). Clozapine successfully treats psychosis in PD. Cholinesterase inhibitors are effective treatments for dementia in PD, but improvement is modest and motor side effects may occur.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the April 11 issue to find the title link for this article.
Editorial, see page 966
See also pages 968, 976, and983
This article was previously published in electronic format as an Expedited E-Pub at www.neurology.org.
Quality Standards Subcommittee Members are listed in appendix E-4 on the Neurology Web site at www.neurology.org.
Approved by QSS July 30, 2005; Practice Committee December 15, 2005; Board of Directors February 23, 2006.
Endorsed by the National Parkinson Foundation and the Parkinson’s Disease Foundation.
Disclosures are provided after the text.
Received September 9, 2005. Accepted in final form February 16, 2006.
This article has been cited by other articles:
|
|
 |
|
  J. J. Chen, D. P. Trombetta, and H. H. Fernandez Palliative Management of Parkinson Disease: Focus on Nonmotor, Distressing Symptoms Journal of Pharmacy Practice, August 1, 2008; 21(4): 262 - 272. [Abstract] [PDF]
|
|
|
|
 |
|
 U. Lertxundi, J. Peral, O. Mora, S. Domingo-Echaburu, M. J. Martinez-Bengoechea, and J. C. Garcia-Monco Antidopaminergic therapy for managing comorbidities in patients with Parkinson's disease Am. J. Health Syst. Pharm., March 1, 2008; 65(5): 414 - 419. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Simonson, R. A Hauser, and A. H. Schapira Role of the Pharmacist in the Effective Management of Wearing-Off in Parkinson's Disease Ann. Pharmacother., November 1, 2007; 41(11): 1842 - 1849. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C E Clarke Parkinson's disease BMJ, September 1, 2007; 335(7617): 441 - 445. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Aarsland, M. Emre, A. Lees, W. Poewe, C. Ballard, E. B. Montgomery, J. M. Miyasaki, and G. Gronseth Practice Parameter: Evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology Neurology, January 2, 2007; 68(1): 80 - 81. [Full Text] [PDF]
|
|
|
|
 |
|
 F. Ferreri, C. Agbokou, and S. Gauthier Recognition and management of neuropsychiatric complications in Parkinson's disease Can. Med. Assoc. J., December 5, 2006; 175(12): 1545 - 1552. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 American Academy of Neurology Practice Parameters: Parkinson Disease Diagnosis and Treatment Journal Watch Neurology, August 1, 2006; 2006(801): 1 - 1. [Full Text]
|
|
|
|
 |
|
 Reviews of Note Journal Watch Psychiatry, June 21, 2006; 2006(621): 2 - 2. [Full Text]
|
|
|
|
|
|
R. L. Albin Practice Parameters for Parkinson disease: signposts for clinical research. Neurology, April 11, 2006; 66(7): 966 - 967. [Full Text] [PDF]
|
|
|
|
|
|
R. L. Albin Practice Parameters for Parkinson disease: signposts for clinical research. Neurology, April 11, 2006; 66(7): 966 - 967. [Full Text] [PDF]
|
|
Read all Correspondence
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
