000151298 001__ 151298
000151298 005__ 20250307114715.0
000151298 0247_ $$2doi$$a10.1155/2021/6621991
000151298 0248_ $$2sideral$$a124255
000151298 037__ $$aART-2021-124255
000151298 041__ $$aeng
000151298 100__ $$aAgüera-Ortiz, L.
000151298 245__ $$aFocus on Depression in Parkinson''s Disease: A Delphi Consensus of Experts in Psychiatry, Neurology, and Geriatrics
000151298 260__ $$c2021
000151298 5060_ $$aAccess copy available to the general public$$fUnrestricted
000151298 5203_ $$aMajor and minor forms of depression are significant contributors to Parkinson''s disease morbidity and caregiver burden, affecting up to 50% of these patients. Nonetheless, symptoms of depression are still underrecognized and undertreated in this context due to scarcity of evidence and, consequently, consistent clinical guideline recommendations. Here, we carried out a prospective, multicentre, 2-round modified Delphi survey with 49 questions about the aetiopathological mechanisms of depression in Parkinson''s disease (10), clinical features and connections with motor and nonmotor symptoms (10), diagnostic criteria (5), and therapeutic options (24). Items were assessed by a panel of 37 experts (neurologists, psychiatrists, and a geriatrist), and consensus was achieved in 81.6% of them. Depressive symptoms, enhanced by multiple patient circumstances, were considered Parkinson''s disease risk factors but not clinical indicators of motor symptom and disease progression. These patients should be systematically screened for depression while ruling out both anhedonia and apathy symptoms as they are not necessarily linked to it. Clinical scales (mainly the Geriatric Depression Scale GDS-15) can help establishing the diagnosis of depression, the symptoms of which will require treatment regardless of severity. Efficacious and well-tolerated pharmacological options for Parkinson''s comorbid depression were selective serotonin reuptake inhibitors (especially sertraline), dual-action serotonin and norepinephrine reuptake inhibitors (venlafaxine, desvenlafaxine, and duloxetine), multimodal (vortioxetine, bupropion, mirtazapine, and tianeptine), and anti-Parkinsonian dopamine agonists (pramipexole, ropinirole, and rotigotine). Tricyclic antidepressants and combining type B monoamine oxidase inhibitors with serotonergic drugs have serious side effects in these patients and therefore should not be prescribed. Electroconvulsive therapy was indicated for severe and drug-refractory cases. Cognitive behavioural therapy was recommended in cases of mild depression. Results presented here are useful diagnostic and patient management guidance for other physicians and important considerations to improve future drug trial design.
000151298 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000151298 590__ $$a3.17$$b2021
000151298 591__ $$aCLINICAL NEUROLOGY$$b119 / 212 = 0.561$$c2021$$dQ3$$eT2
000151298 592__ $$a0.656$$b2021
000151298 593__ $$aPsychiatry and Mental Health$$c2021$$dQ2
000151298 593__ $$aNeurology (clinical)$$c2021$$dQ2
000151298 594__ $$a4.6$$b2021
000151298 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000151298 700__ $$aGarcía-Ramos, R.
000151298 700__ $$aGrandas Pérez, F.J.
000151298 700__ $$aLópez-Álvarez, J.
000151298 700__ $$aMontes Rodríguez, J.M.
000151298 700__ $$aOlazarán Rodríguez, F.J.
000151298 700__ $$aOlivera Pueyo, J.$$uUniversidad de Zaragoza
000151298 700__ $$0(orcid)0000-0002-4036-4541$$aPelegrín Valero, C.$$uUniversidad de Zaragoza
000151298 700__ $$aPorta-Etessam, J.
000151298 7102_ $$11007$$2745$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Psiquiatría
000151298 773__ $$g2021, 6621991 (2021), [11 pp.]$$pParkinson's dis.$$tParkinson's Disease$$x2090-8083
000151298 8564_ $$s1246599$$uhttps://zaguan.unizar.es/record/151298/files/texto_completo.pdf$$yVersión publicada
000151298 8564_ $$s2401415$$uhttps://zaguan.unizar.es/record/151298/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000151298 909CO $$ooai:zaguan.unizar.es:151298$$particulos$$pdriver
000151298 951__ $$a2025-03-07-09:31:37
000151298 980__ $$aARTICLE