Depresja w chorobie Parkinsona. Rola farmakoterapii

• Authors: Piotr Wierzbiński , Tomasz Sobów

Title variants

EN

Depression in Parkinson’s disease. The role of pharmacotherapy

• Languages of publication: PL

Abstracts

PL

Objawy psychiatryczne wydają się immanentną częścią choroby Parkinsona. U pacjentów mogą wystąpić objawy psychotyczne, zaburzenia funkcji poznawczych, zaburzenia snu (związane przede wszystkim ze snem REM), zespół otępienny, objawy zespołu depresyjnego i zaburzenia lękowe. Depresja i lęk są najczęstszymi zaburzeniami psychiatrycznymi, obecnymi u prawie połowy osób z chorobą Parkinsona. U podstaw objawów depresyjnych i lękowych leżą zarówno zmiany neurochemiczne, jak i zmiany neuroanatomiczne występujące w tej chorobie. Obniżają one jakość życia, istotnie wpływają na funkcjonowanie pacjenta, a ich pojawienie się często nie jest właściwie rozpoznawane. Na podstawie licznych badań wiadomo, że najczęściej stosowane są leki z grupy selektywnych inhibitorów wychwytu zwrotnego serotoniny. Brakuje niestety mocnych dowodów na ich dużą skuteczność. Z uwagi na wielomediatorowy mechanizm działania dobrym wyborem – bardziej efektywnym, ale też związanym z większą liczbą działań niepożądanych – mogą być selektywne inhibitory wychwytu zwrotnego noradrenaliny i trójpierścieniowe leki przeciwdepresyjne. Jak wynika z codziennej praktyki i licznych publikacji, alternatywą dla leków przeciwdepresyjnych są nieergolinowi agoniści dopaminy, tacy jak ropinirol czy pramipeksol.

EN

Psychiatric symptoms seem to be an immanent part of Parkinson’s disease. Patients may present with psychotic symptoms, cognitive disorders, sleep disturbances (mainly associated with the REM sleep), dementia as well as depression and anxiety. Depression and anxiety are the most common psychiatric disorders, and are observed in nearly a half of patients with Parkinson’s disease. They are caused by both neurochemical and neuroanatomical abnormalities occurring in this disease. This decreases the quality of life and significantly affects patients’ functioning. Moreover, these disorders are frequently not diagnosed correctly. Numerous studies have shown that the most common drugs are those from the group of selective serotonin reuptake inhibitors. However, there is no strong evidence for their high efficacy. Due to the multifactorial mechanism of action, more effective, but also related with more adverse events, are selective norepinephrine reuptake inhibitors and tricyclic antidepressants. Daily practice and various publications reveal that non-ergoline dopamine agonists, such as ropinirole and pramipexole, may constitute an alternative to antidepressants.

Keywords

EN

agoniści dopaminy; choroba Parkinsona; depresja; lęk

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Aktualności Neurologiczne
• Year: 2018
• Volume: 18
• Issue: 1
• Pages: 14–20

Contributors

author

Piotr Wierzbiński

• Poradnia Zdrowia Psychicznego Medsolver, Łódź, Polska

author

Tomasz Sobów

• Zakład Psychologii Lekarskiej, Uniwersytet Medyczny w Łodzi, Łódź, Polska

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• Document Type: article