What are the Treatment Options for Depression?

There are two main types of treatment for depression, medical management, which includes antidepressants and non-medical management, which includes psychotherapy, etc. Please be aware that each individual responds differently to the various treatment options and will have their own individual treatment plans.

Medication Therapy

Most depressed patients are treated with a selective serotonin reuptake inhibitor (SSRI) such as:

• fluoxetine (Prozac®)
• sertraline (Zoloft®)
• paroxetine (Paxil®)
• citalopram (Celexa®)
• escitalopram (Lexapro®)
• *Please note, depression may be under-treated in many people with PD. If one trial of antidepressant medication fails, other medications, combinations of medications, or alternative treatments should be tried until symptoms are under control.
• These medications work equally well, though they differ slightly in their side effects and interactions with other medications.
• There are also several non-SSRI antidepressants used to treat depression including:
  • venlafaxine (Effexor®)
  • mirtazapine (Remeron®)
  • buproprion (Wellbutrin®)
  • And an older class of medication called tricyclic antidepressants.

People with PD who suffer from mental health comorbidities should not be given amoxapine.  If they are taking an MAO-B inhibitor for their PD, the current practice is to avoid concurrent tricyclic, SSRI, or SNRI antidepressants.  There is some controversy on this point, and some neurologists and neuropsychs are comfortable prescribing an MAO-B inhibitor concurrently with antidepressants if done under their close supervision.  For hallucinations and delusions, PD patients shouldn’t be on any neuroleptics except for quetiapine or clozapine.

Medical content reviewed by: Nina Browner, MD—Medical Director of the NPF Center of Excellence at the University of North Carolina at Chapel Hill in North Carolina and by Fernando Pagan, MD—Medical Director of the NPF Center of Excellence at Georgetown University Hospital in Washington, D.C.

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