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Antidepresivos en la enfermedad de Parkinson. Recomendaciones del grupo de trastornos del movimiento de la Asociación Madrileña de Neurología. [revisión]

Por: Posada Rodríguez, Ignacio Javier [ Neurología, ].
Colaborador(es): Servicio de Neurología-Neurofisiología.
Tipo de material: materialTypeLabelArtículoEditor: Neurología, 2018Descripción: 33(6):395-402.Recursos en línea: Solicitar documento Resumen: Introduction: Although antidepressants are widely used in Parkinson's disease (PD), few well-designed studies to support their efficacy have been conducted. Development: These clinical guidelines are based on a review of the literature and the results of an AMN movement disorder study group survey. Conclusions: Evidence suggests that nortriptyline, venlafaxine, paroxetine, and citalopram may be useful in treating depression in PD, although studies on paroxetine and citalopram yield conflicting results. In clinical practice, however, selective serotonin reuptake inhibitors are usually considered the treatment of choice. Duloxetine may be an alternative to venlafaxine, although the evidence for this is less, and venlafaxine plus mirtazapine may be useful in drug-resistant cases. Furthermore, citalopram may be indicated for the treatment of anxiety, atomoxetine for hypersomnia, trazodone and mirtazapine for insomnia and psychosis, and bupropion for apathy. In general, antidepressants are well tolerated in PD. However, clinicians should consider the anticholinergic effect of tricyclic antidepressants, the impact of serotonin-norepinephrine reuptake inhibitors on blood pressure, the extrapyramidal effects of antidepressants, and any potential interactions between monoamine oxidase B inhibitors and other antidepressants.
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Formato Vancouver:
Peña E, Mata M, López Manzanares L, Kurtis M, Eimil M, Martínez Castrillo JC et al; en nombre del grupo de trastornos del movimiento de la Asociación Madrileña de Neurología. Antidepresivos en la enfermedad de Parkinson. Recomendaciones del grupo de trastornos del movimiento de la Asociación Madrileña de Neurología. Neurologia. 2018;33(6):395-402.

PMID: 27004670

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Introduction: Although antidepressants are widely used in Parkinson's disease (PD), few well-designed studies to support their efficacy have been conducted.
Development: These clinical guidelines are based on a review of the literature and the results of an AMN movement disorder study group survey.
Conclusions: Evidence suggests that nortriptyline, venlafaxine, paroxetine, and citalopram may be useful in treating depression in PD, although studies on paroxetine and citalopram yield conflicting results. In clinical practice, however, selective serotonin reuptake inhibitors are usually considered the treatment of choice. Duloxetine may be an alternative to venlafaxine, although the evidence for this is less, and venlafaxine plus mirtazapine may be useful in drug-resistant cases. Furthermore, citalopram may be indicated for the treatment of anxiety, atomoxetine for hypersomnia, trazodone and mirtazapine for insomnia and psychosis, and bupropion for apathy. In general, antidepressants are well tolerated in PD. However, clinicians should consider the anticholinergic effect of tricyclic antidepressants, the impact of serotonin-norepinephrine reuptake inhibitors on blood pressure, the extrapyramidal effects of antidepressants, and any potential interactions between monoamine oxidase B inhibitors and other antidepressants.

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