Friday, August 20, 2010
PD, Depression, and Pharmacology
We actively screen for indicators of depression in our clinic using the Center for Epidemiological Studies-Depression (CES-D) scale. If they haven't already done so our providers then have the conversation with our patients about the issue of Depression and PD. First-line treatments are usually pharmacological; the SSRIs, SNRIs, and occasionally the Tricyclic antidepressants. Depending on the circumstances they will then refer the patient to see me. We also refer patients for counseling, particularly if they are not getting much symptomatic benefit from pharmacology.
A 2010 study in the Journal of American Medicine seems to call into question the effects of pharmacology on mild to moderate depression. This is very interesting considering the wide-spread use of pharmacology in the treatment of depression.
Another interesting factor in the treatment of depression are the recent findings that pharmaceutical companies were selective in their publishing of articles demonstrating the effects of drugs to treat depression.
Depression has been found to have the greatest influence on quality of life in PWP, making the role of the SW in working with PD that much more important.