Just as the symptoms and causes of depression can differ from person to person, so too can suitable treatment approaches. There are two main types of treatment options for depression: antidepressant medications and psychological counseling (psychotherapy).
NPF recommends a holistic, comprehensive approach to depression. Although antidepressants are often effective in reducing symptoms, they should seldom be used alone. In most cases, the best approach is a combination of antidepressant medication, counseling, exercise and social support.
The following are treatment options for depression.
Most people with depression are treated with a class of drugs called selective serotonin reuptake inhibitors (SSRIs). They include:
- fluoxetine (Prozac®)
- sertraline (Zoloft®)
- paroxetine (Paxil®)
- citalopram (Celexa®)
- escitalopram (Lexapro®)
In addition, there are several non-SSRI antidepressants used to treat depression. They include:
- venlafaxine (Effexor®)
- mirtazapine (Remeron®)
- buproprion (Wellbutrin®)
- tricyclic antidepressants (Amoxapine)
These medications work equally well, though they differ slightly in their side effects and interactions with other medications. But individuals do not react the same way to these drugs, so if one trial of antidepressant medication fails, another medication, or combination of medications, as well as complementary treatments should be tried until symptoms are under control. It can take some trial and error to find the right treatment.
Note: 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 (serotonin and norepinephrine reuptake inhibitor) antidepressants . There is some controversy on this point, and some neurologists and neuropsychologists are comfortable prescribing an MAO-B inhibitor concurrently with antidepressants if done under their close supervision. For hallucinations and delusions, PD patients shouldn’t take any neuroleptics except for quetiapine or clozapine.
Page reviewed by Dr. Joash Lazarus, NPF Movement Disorders Fellow, Department of Neurology at Emory University School of Medicine.