Anxiety in Parkinson's disease: identification and management

Chen, Jack J.; Marsh, Laura

doi:10.1177/1756285613495723

Cited by 161Parkinson's Disease Mechanisms and TreatmentsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeurological disorders and treatments

Anxiety in Parkinson's disease: identification and management

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Chen, Jack J., Marsh, Laura·2014·Therapeutic Advances in Neurological Disorders

DOI 10.1177/1756285613495723PMC PMC3886380

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Abstract

Anxiety disturbances are recognized as common psychiatric comorbidities in Parkinson’s disease (PD) and contribute to significant impairments in areas of cognitive, functional, motor and social performance. Anxiety in PD results in reduced quality of life, higher levels of care dependency and increased caregiver burden. Surprisingly, there is a paucity of treatment data. In one randomized, controlled study, bromazepam was found to be effective for anxiety in PD. However, usage of benzodiazepines in the PD population is limited by potential risk of confusion and falls. There are no controlled studies of selective serotonin reuptake inhibitors (SSRIs) for anxiety in PD. However, results from uncontrolled studies suggest that SSRIs are effective for anxiety in PD, although in these studies anxiety outcomes were secondary. This review underscores that, given the high prevalence of anxiety disturbances in PD, there is a significant paucity of treatment data for this population. Additional studies are warranted. In the meantime, clinicians should rely on empiric assessments of known risks and putative benefits to guide treatment decisions. Cognitive and behavioral therapies (with or without pharmacotherapy) have demonstrated efficacy and warrant consideration. When feasible, a targeted and individualized multimodal approach utilizing psychotherapeutic interventions along with pharmacologic therapies should be considered.

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Concerns regarding unfavorable side effects, including exacerbation of motor problems in patients with complex medication regimes, have been noted.
“concerns regarding unfavorable side effects, including exacerbation of motor problems in patients with complex medication regimes, have been noted (Rabinstein and Shulman, 2000”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Chen and Marsh, 2014
The Introduction reports that SSRIs can occasionally worsen tremor and that reversible worsening of parkinsonism has been reported, though it is uncommon. It also discusses a separate concern about combining SSRIs with MAO-B inhibitors, but does not link motor worsening specifically to patients with complex medication regimens. (LLM, conf=0.84)
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Anxiety in Parkinson’s Disease
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Authors: Chen, J. J., & Marsh, L.
Affiliations: Loma Linda University (US)
Michael E. DeBakey VA Medical Center (US)
ORCID: Chen, Jack J.
Marsh, Laura
Venue: Therapeutic Advances in Neurological Disorders
Publisher: SAGE Publications
Published: 2013-07-17
Volume: 7
Issue: 1
Pages: 52-59
ISSN: 1756-2856 (ISSN-L)
1756-2864
DOI: 10.1177/1756285613495723
PMC: PMC3886380
OpenAlex: W2149341227
Cited by: 161
References: 69
Citations by year: 2026: 12 · 2025: 14 · 2024: 18 · 2023: 10 · 2022: 17 · 2021: 20 · 2020: 15 · 2019: 15 · 2018: 7 · 2017: 8 · 2016: 10 · 2015: 10 · 2014: 5
FWCI: 1.09
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Therapeutic Advances in Neurological Disorders (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics: Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Neurology › Neurological disorders and treatments
Keywords: Parkinson's disease, anxiety, psychiatric comorbidity, benzodiazepines, bromazepam, selective serotonin reuptake inhibitors, multimodal therapy, quality of life, caregiver burden, fall risk

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Anxiety in Parkinson's disease: identification and management

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