Imagine living in a world where each day brings new challenges beyond physical limitations. For people living with Parkinson's Disease (PD), this is a daily reality. The elderly in their 60s with this condition often struggle with both the visible tremors and rigidity and the less visible but equally debilitating depression and anxiety. To understand ways to manage depression in patients with Parkinson’s Disease, the Onlymyhealth team spoke to Dr Praveen Gupta, Principal Director & Head, Neurology, Fortis Hospitals, Gurgaon.
Depression And Parkinson’s Disease
Parkinson’s Disease is plagues by many physical disorders. Dr Gupta said, “With Parkinson’s Disease, people often wake up feeling exhausted due to common non-motor symptoms like sleep disorders like insomnia and REM sleep behaviour disorder.”
However, persistent depression and anxiety often overshadow physical symptoms. “Hallucinations occasionally add to this distress, making the patients question reality and adding to their emotional burden. These non-motor symptoms are just as challenging as the physical ones, significantly affecting his mental health and quality of life,” he said.
Dr Gupta listed other factors that add to a patient of Parkinson’s Disease being depressed:
While motor symptoms are more noticeable, slow movements, muscle stiffness, and tremours make simple tasks like buttoning a shirt or cooking breakfast arduous.
Cognitive impairment also hinders the ability to think clearly and remember things, while occasional psychosis episodes add confusion and fear.
“These motor symptoms require constant management, and finding a balance in treatment is crucial for maintaining some degree of independence,” he said.
He added, “However, not only in the elderly population, depression is also becoming increasingly common amongst the younger population with Parkinson’s Diseases.”
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Treating Depression In Parkonson’s Disease
Traditional treatments of Parkinson’s Disease often involve dopamine-based drugs like carbidopa and levodopa, infoemed Dr Gupta. “While these medications help manage motor symptoms, they come with a downside. Depression and anxiety may worsen for some people after starting these drugs, complicating the treatment. This dual impact makes it hard for the patient and the doctor to find an effective management plan, highlighting the need for alternatives that don't exacerbate non-motor symptoms.”
Enter Apomorphine, a dopamine agonist used in managing Parkinson’s Disease. “Apomorphine has shown promise in controlling motor symptoms without significantly worsening non-motor symptoms. This characteristic makes it a valuable option for patients who need comprehensive symptom management,” said Dr Gupta.
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“Research and case studies support the efficacy of Apomorphine in improving motor symptoms. Studies have shown that patients experience fewer tremors, reduced muscle stiffness, and better overall movement. More importantly, Apomorphine does not significantly worsen non-motor symptoms,” he said.
For people with Parkinson’s Disease and depression, this helps them manage physical symptoms without further compromising mental health, allowing for a more balanced and improved quality of life.
Dr Gupta concluded that by embracing treatments like Apomorphine that offer a balanced approach to managing both motor and non-motor symptoms, we can significantly enhance the quality of life for people living with Parkinson's Disease.