Research Article

Focus on Depression in Parkinson’s Disease: A Delphi Consensus of Experts in Psychiatry, Neurology, and Geriatrics

Table 4

Section IV: treatment of depression in PD patients.

StatementConsensus agreementConsensus disagreementNo consensus

S26TCAs have important side effects in PD patients.
S27The best-tolerated SSRI for PD patients is sertraline.
S28The dual SNRIs are effective in PD patients with major depression.
S29Among TCAs, nortriptyline shows the best safety profile in PD patients.
S30SSRIs and SNRIs (dual) worsen motor symptoms of PD.-
S31Mirtazapine is an effective and well-tolerated antidepressant drug for PD patients.
S32Agomelatine, with norepinephrinergic and indirect dopaminergic effects, is not a drug of choice in PD patients.-
S33The DA and NE reuptake inhibitor bupropion is effective in PD patients.
S34Nonergotic DA-receptor agonists (ropinirole, pramipexole, and rotigotine) are effective for treating PD-related depression.
S35The glutamatergic modulator tianeptine is effective for depression in PD patients.
S36CBT is effective to treat depression in PD patients.
S37Trazodone is an effective treatment for depression in PD.-
S38Combining anti-Parkinsonian MAO-BIs and serotonergic antidepressants is of limited use given the possible occurrence of a serotonin syndrome in PD.
S39Tianeptine is a safe antidepressant in depressive PD patients under treatment with anti-Parkinsonian drugs.
S40Vortioxetine is a multimodal antidepressant that is well tolerated in PD patients.
S41ECT is an advisable therapeutic approach in patients with dementia and depression that show poor response to antidepressants.
S42Given their PD-specific efficacy and tolerability, SSRIs are a good treatment option for depression in PD patients.
S43Given their PD-specific efficacy and tolerability, dual and multimodal drugs are a good treatment option for depression in PD patients.
S44Given its PD-specific efficacy and tolerability, mirtazapine is a good treatment option for depression in PD patients.
S45Given its PD-specific efficacy and tolerability, bupropion is a good treatment option for depression in PD patients.
S46Given its PD-specific efficacy and tolerability, nortriptyline is a good treatment option for depression in PD patients.-
S47Given its PD-specific efficacy and tolerability, agomelatine is a good treatment option for depression in PD patients.-
S48Given its PD-specific efficacy and tolerability, tianeptine is a good treatment option for depression in PD patients.
S49Given its PD-specific efficacy and tolerability, trazodone is a good treatment option for depression in PD patients.-

TCAs, tricyclic antidepressants; PD, Parkinson’s disease; SSRIs, selective serotonin reuptake inhibitors; DA, dopamine; NE, norepinephrine; SNRIs, serotonin and NE reuptake inhibitors; MAO-BIs, type B monoamine oxidase inhibitors; ECT, electroconvulsive therapy; CBT, cognitive behavioural therapy.