As an attending psychiatrist at Mount Auburn Hospital in Cambridge, Massachusetts, Dr. Antonio Bullon builds on more than a decade of experience with both inpatient and outpatient populations. Focused on the care of geriatric patients since 2012, Dr. Antonio Bullon draws on an in-depth knowledge of Parkinson’s disease and its psychiatric symptoms.
Parkinson’s disease stands out as the second most prevalent neurodegenerative condition in the United States today. It is perhaps best known for its characteristic motor disturbances, which include tremor and balance issues, though it also predisposes patients to a range of psychiatric issues. The most common of these is depression, which affects approximately 40 percent of patients with Parkinson’s disease.
Close to 20 percent of patients with Parkinson’s disease experience major clinical depression, while the remaining 20 percent face a less severe form known as dysthymia. Its symptoms, including low mood and decreased motivation, correlate with a more rapid loss of motor skills and an increased overall cognitive decline. Affected patients also demonstrate reduced capacities for self-care and treatment compliance, while their caregivers experience higher levels of distress.
Dementia is nearly as common in patients with Parkinson’s disease. It presents a more severe form of the cognitive decline that is prevalent throughout the illness, though clinical dementia typically presents later in the course of the illness. Studies suggest that percentage of comorbidity between Parkinson’s and dementia continues to increase concurrent with duration of the illness, one population having showed a 78 percent correlation 17 years after diagnosis.
While depression and dementia remain the most common co-morbidities with the disease itself, certain treatments may predispose a patient to visual hallucinations and other psychoses. These symptoms are most common in patients taking postsynaptic dopamine agonists and may abate with medication changes. However, because some patients cannot tolerate change in medication without a worsening of motor symptoms, some may turn to specific antipsychotic drugs.
Patients diagnosed with Parkinson’s disease and depression should consult a physician to discuss potential treatments. Dementia may be more difficult to treat, though some newer drugs seem promising with certain populations.