According to the National Parkinson Foundation, as many as 40 percent of patients with Parkinson's disease (PD) experience some form of anxiety. PD depression--in particular, depression that co-exists with anxiety--is associated with an increase in symptom progression and a greater decline in cognitive skills and the ability to attend to self-care tasks, such as bathing, dressing and grooming. When anxiety and depression are treated and managed, quality of life can improve.
SSRIs
Many physicians treat PD anxiety and depression with a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). The effectiveness of SSRIs with PD depression and anxiety was confirmed after a 2004 study published by the American Psychiatric Press titled "Citalopram Treatment of Depression in Parkinson's Disease: The Impact on Anxiety, Disability, and Cognition." Doctors administered the SSRI citalopram to 10 PD subjects with comorbid anxiety (depression with anxiety). The study revealed that depression and anxiety symptoms, along with functional impairment, significantly improved. The National Parkinson Foundation recommends administering a low initial dose of SSRI for treating anxiety attacks. The foundation's website says high initial dosages of SSRI can increase anxiety attacks.
Benzodiazepines
A class of anti-anxiety medications known as benzodiazepines also is used to treat anxiety disorders. Examples include Valium, Ativan, Xanax and Klonipin. These medications take effect quickly and can rapidly improve anxiety-related symptoms in PD patients. They also can help with tremors, muscle changes and sleep changes associated with PD. Because benzodiazepines can build up in the system, and because they can impair functioning and balance because of sedation and drowsiness, doctors administer them with caution. Benzodiazepines also can lead to memory troubles and confusion, according to the National Parkinson Foundation. When stopping the medication, patients must be weaned under doctors' supervision to avoid serious withdrawal symptoms.
Medication Alternatives
The National Parkinson Foundation also recommends a variety of alternative treatments that can be used in conjunction with or in lieu of medications, depending on patient preference and medical advice. Behavioral therapy that focuses on disease and symptom education, along with behavioral modification, can provide patient support while helping manage anxiety symptoms. Exercise also can help improve mood and relieve anxiety. Relaxation techniques such as meditation, deep-breathing exercises, yoga, massage and aromatherapy all have anecdotal evidence to suggest that they can help alleviate anxiety symptoms.
