Abstract：
:In patients with Parkinson's disease (PD) disturbances of mental state constitute some of the most difficult treatment challenges of advanced disease, often limiting effective treatment of motor symptoms and leading to increased disability and poor quality of life. This article provides an update on the current knowledge of these complications and the use of old and new drugs in their management. Mental state alterations in PD include depression, anxiety, cognitive impairment, apathy, and treatment-related psychiatric symptoms. The latter range from vivid dreams and hallucinations to delusions, manic symptoms, hypersexuality, dopamine dysregulation syndrome and delirium. While some of these symptoms may be alleviated by anti-parkinsonian medication, especially if they are off-period related, treatment-related phenomena are usually exacerbated by increasing the number or dosage of antiparkinsonian drugs. Elimination of exacerbating factors and simplification of drug regimes are the first and most important steps in improvement of such symptoms. However, the advent of atypical antipsychotics such as clozapine has dramatically helped the management of treatment-related psychiatric complications in PD. In patients with dementia associated with PD cognitive functioning and behavioural problems appear to respond to cholinesterase inhibitors, such as rivastigmine or donepezil. Depression is a common problem in early as well as advanced PD, and selective serotonin reuptake inhibitors, reboxetine, and tricyclic antidepressants have been reported to be effective and well tolerated antidepressants. Randomised, controlled studies are required to assess the differential efficacy and tolerability of antidepressants in patients with PD, including the newer antidepressants with serotonergic and noradrenergic properties.
journal_name
J Neuroljournal_title
Journal of neurologyauthors
Schrag Adoi
10.1007/s00415-004-0483-3keywords:
subject
Has Abstractpub_date
2004-07-01 00:00:00pages
795-804issue
7eissn
0340-5354issn
1432-1459journal_volume
251pub_type
杂志文章,评审abstract：:The emotional and relationship problems associated with MS have not always been fully appreciated by the medical profession, which has tended to concentrate on the physical aspects of this disease. Yet the psychological problems of MS often cause more suffering than physical effects. ...
journal_title：Journal of neurology
pub_type： 杂志文章,评审
doi：10.1007/s004150170223
更新日期：2001-03-01 00:00:00
abstract：OBJECTIVE:To determine the prevalence and characteristics of the cricopharyngeal bar (CPB), defined as marked protrusion with lacking relaxation and stricture of the upper esophageal sphincter on videofluoroscopy, in patients with inclusion body myositis (IBM). METHODS:We conducted a case-control study of comprehensiv...
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pub_type： 杂志文章
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journal_title：Journal of neurology
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pub_type： 杂志文章
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pub_type： 杂志文章
doi：10.1007/s00415-015-7925-y
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journal_title：Journal of neurology
pub_type： 杂志文章,评审
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更新日期：2010-11-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/BF00314215
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journal_title：Journal of neurology
pub_type： 杂志文章,多中心研究
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更新日期：2014-05-01 00:00:00
abstract：:The three main immunoglobulin classes obey the basic principles of passive protein transfer at the blood-CSF barrier and the serum-derived portions could therefore be quantified with the help of the permeability marker albumin. The Ig fractions secreted into the CSF by sessile plasma cell clones have been determined i...
journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/BF00313413
更新日期：1982-01-01 00:00:00
abstract：OBJECTIVE:Determine toxicity and efficacy of autologous hematopoietic stem cell transplantation (HSCT) for patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) who are dependent on intravenous immunoglobulins or plasmapheresis. METHODS:Unselected peripheral blood stem cells were re-infused on...
journal_title：Journal of neurology
pub_type： 杂志文章
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更新日期：2020-11-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/s00415-020-10086-0
更新日期：2020-12-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/s00415-008-0636-x
更新日期：2008-02-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/BF00868999
更新日期：1996-05-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/s00415-015-7766-8
更新日期：2015-05-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章,评审
doi：10.1007/s00415-011-6063-4
更新日期：2011-08-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/s00415-008-0929-0
更新日期：2008-09-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/s00415-006-0109-z
更新日期：2006-06-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/s00415-0060-0254-4
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pub_type： 杂志文章
doi：10.1007/s00415-002-0707-3
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pub_type： 临床试验,杂志文章
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更新日期：1997-09-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/BF00314641
更新日期：1979-10-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章,meta分析
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更新日期：2020-02-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章,评审
doi：10.1007/pl00007768
更新日期：2000-09-01 00:00:00
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journal_title：Journal of neurology
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更新日期：2005-02-01 00:00:00
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pub_type： 杂志文章,多中心研究
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pub_type： 杂志文章
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更新日期：1985-01-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
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更新日期：2018-02-01 00:00:00
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journal_title：Journal of neurology
pub_type： 杂志文章
doi：10.1007/s00415-005-0617-2
更新日期：2005-01-01 00:00:00
