ParkinsonV1, Main, Corpus, bibRecord, 000957

Current Issues in Depression in Parkinson's Disease

Identifieur interne : 000957 ( Main/Corpus ); précédent : 000956; suivant : 000958

Current Issues in Depression in Parkinson's Disease

Auteurs : Theresa A. Zesiewicz ; Michael Gold ; Ganesh Chari ; Robert A. Hauser

Source :

The American Journal of Geriatric Psychiatry [ 1064-7481 ] ; 1998.

RBID : ISTEX:437EFFEF2C350B16AA41EF7FA65ED538ECBE895F

Abstract

Depression affects 4050 of Parkinson's disease (PD) patients. The authors, by use of a Mednet and manual search of pertinent literature, summarize current issues in the treatment of depression in PD. Open-label studies suggest that antidepressants may be effective for treating depression in PD. Although case reports indicate that selective serotonin reuptake inhibitors (SSRIs) can potentially worsen the motor symptoms of PD, this effect has not been confirmed in the small number of open-label studies that have been performed to date. The occurrence of the serotonin syndrome resulting from a combination of selegiline and an SSRI appears to be rare. Double-blind prospective studies are needed to evaluate the safety and efficacy of antidepressants in PD and their effect on motor function.

Url:

https://api.istex.fr/document/437EFFEF2C350B16AA41EF7FA65ED538ECBE895F/fulltext/pdf

DOI: 10.1097/00019442-199905000-00003

Links to Exploration step

ISTEX:437EFFEF2C350B16AA41EF7FA65ED538ECBE895F

Le document en format XML

<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Current Issues in Depression in Parkinson's Disease</title>
<author><name sortKey="Zesiewicz, Theresa A" sort="Zesiewicz, Theresa A" uniqKey="Zesiewicz T" first="Theresa A." last="Zesiewicz">Theresa A. Zesiewicz</name>
<affiliation><mods:affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Gold, Michael" sort="Gold, Michael" uniqKey="Gold M" first="Michael" last="Gold">Michael Gold</name>
<affiliation><mods:affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Chari, Ganesh" sort="Chari, Ganesh" uniqKey="Chari G" first="Ganesh" last="Chari">Ganesh Chari</name>
<affiliation><mods:affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Hauser, Robert A" sort="Hauser, Robert A" uniqKey="Hauser R" first="Robert A." last="Hauser">Robert A. Hauser</name>
<affiliation><mods:affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</mods:affiliation>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">ISTEX</idno>
<idno type="RBID">ISTEX:437EFFEF2C350B16AA41EF7FA65ED538ECBE895F</idno>
<date when="1999" year="1999">1999</date>
<idno type="doi">10.1097/00019442-199905000-00003</idno>
<idno type="url">https://api.istex.fr/document/437EFFEF2C350B16AA41EF7FA65ED538ECBE895F/fulltext/pdf</idno>
<idno type="wicri:Area/Main/Corpus">000957</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title level="a">Current Issues in Depression in Parkinson's Disease</title>
<author><name sortKey="Zesiewicz, Theresa A" sort="Zesiewicz, Theresa A" uniqKey="Zesiewicz T" first="Theresa A." last="Zesiewicz">Theresa A. Zesiewicz</name>
<affiliation><mods:affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Gold, Michael" sort="Gold, Michael" uniqKey="Gold M" first="Michael" last="Gold">Michael Gold</name>
<affiliation><mods:affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Chari, Ganesh" sort="Chari, Ganesh" uniqKey="Chari G" first="Ganesh" last="Chari">Ganesh Chari</name>
<affiliation><mods:affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</mods:affiliation>
</affiliation>
</author>
<author><name sortKey="Hauser, Robert A" sort="Hauser, Robert A" uniqKey="Hauser R" first="Robert A." last="Hauser">Robert A. Hauser</name>
<affiliation><mods:affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</mods:affiliation>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j">The American Journal of Geriatric Psychiatry</title>
<title level="j" type="abbrev">AMGP</title>
<idno type="ISSN">1064-7481</idno>
<imprint><publisher>ELSEVIER</publisher>
<date type="published" when="1998">1998</date>
<biblScope unit="volume">7</biblScope>
<biblScope unit="issue">2</biblScope>
<biblScope unit="page" from="110">110</biblScope>
<biblScope unit="page" to="118">118</biblScope>
</imprint>
<idno type="ISSN">1064-7481</idno>
</series>
<idno type="istex">437EFFEF2C350B16AA41EF7FA65ED538ECBE895F</idno>
<idno type="DOI">10.1097/00019442-199905000-00003</idno>
<idno type="PII">S1064-7481(12)61204-4</idno>
</biblStruct>
</sourceDesc>
<seriesStmt><idno type="ISSN">1064-7481</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass></textClass>
<langUsage><language ident="en">en</language>
</langUsage>
</profileDesc>
</teiHeader>
<front><div type="abstract">Depression affects 4050 of Parkinson's disease (PD) patients. The authors, by use of a Mednet and manual search of pertinent literature, summarize current issues in the treatment of depression in PD. Open-label studies suggest that antidepressants may be effective for treating depression in PD. Although case reports indicate that selective serotonin reuptake inhibitors (SSRIs) can potentially worsen the motor symptoms of PD, this effect has not been confirmed in the small number of open-label studies that have been performed to date. The occurrence of the serotonin syndrome resulting from a combination of selegiline and an SSRI appears to be rare. Double-blind prospective studies are needed to evaluate the safety and efficacy of antidepressants in PD and their effect on motor function.</div>
</front>
</TEI>
<istex><corpusName>elsevier</corpusName>
<author><json:item><name>Theresa A. Zesiewicz M.D.</name>
<affiliations><json:string>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</json:string>
</affiliations>
</json:item>
<json:item><name>Michael Gold M.D.</name>
<affiliations><json:string>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</json:string>
</affiliations>
</json:item>
<json:item><name>Ganesh Chari M.D.</name>
<affiliations><json:string>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</json:string>
</affiliations>
</json:item>
<json:item><name>Robert A. Hauser M.D.</name>
<affiliations><json:string>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</json:string>
</affiliations>
</json:item>
</author>
<language><json:string>eng</json:string>
</language>
<abstract>Depression affects 4050 of Parkinson's disease (PD) patients. The authors, by use of a Mednet and manual search of pertinent literature, summarize current issues in the treatment of depression in PD. Open-label studies suggest that antidepressants may be effective for treating depression in PD. Although case reports indicate that selective serotonin reuptake inhibitors (SSRIs) can potentially worsen the motor symptoms of PD, this effect has not been confirmed in the small number of open-label studies that have been performed to date. The occurrence of the serotonin syndrome resulting from a combination of selegiline and an SSRI appears to be rare. Double-blind prospective studies are needed to evaluate the safety and efficacy of antidepressants in PD and their effect on motor function.</abstract>
<qualityIndicators><score>8.452</score>
<pdfVersion>1.7</pdfVersion>
<pdfPageSize>612 x 792 pts (letter)</pdfPageSize>
<refBibsNative>true</refBibsNative>
<keywordCount>0</keywordCount>
<abstractCharCount>796</abstractCharCount>
<pdfWordCount>5499</pdfWordCount>
<pdfCharCount>35831</pdfCharCount>
<pdfPageCount>9</pdfPageCount>
<abstractWordCount>121</abstractWordCount>
</qualityIndicators>
<title>Current Issues in Depression in Parkinson's Disease</title>
<pii><json:string>S1064-7481(12)61204-4</json:string>
</pii>
<genre><json:string>research-article</json:string>
</genre>
<host><volume>7</volume>
<pii><json:string>S1064-7481(12)X6099-8</json:string>
</pii>
<pages><last>118</last>
<first>110</first>
</pages>
<issn><json:string>1064-7481</json:string>
</issn>
<issue>2</issue>
<genre><json:string>Journal</json:string>
</genre>
<language><json:string>unknown</json:string>
</language>
<title>The American Journal of Geriatric Psychiatry</title>
<publicationDate>1999</publicationDate>
</host>
<categories><wos><json:string>GERONTOLOGY</json:string>
<json:string>GERIATRICS & GERONTOLOGY</json:string>
<json:string>PSYCHIATRY</json:string>
</wos>
</categories>
<publicationDate>1998</publicationDate>
<copyrightDate>1999</copyrightDate>
<doi><json:string>10.1097/00019442-199905000-00003</json:string>
</doi>
<id>437EFFEF2C350B16AA41EF7FA65ED538ECBE895F</id>
<fulltext><json:item><original>true</original>
<mimetype>application/pdf</mimetype>
<extension>pdf</extension>
<uri>https://api.istex.fr/document/437EFFEF2C350B16AA41EF7FA65ED538ECBE895F/fulltext/pdf</uri>
</json:item>
<json:item><original>true</original>
<mimetype>text/plain</mimetype>
<extension>txt</extension>
<uri>https://api.istex.fr/document/437EFFEF2C350B16AA41EF7FA65ED538ECBE895F/fulltext/txt</uri>
</json:item>
<json:item><original>false</original>
<mimetype>application/zip</mimetype>
<extension>zip</extension>
<uri>https://api.istex.fr/document/437EFFEF2C350B16AA41EF7FA65ED538ECBE895F/fulltext/zip</uri>
</json:item>
<istex:fulltextTEI uri="https://api.istex.fr/document/437EFFEF2C350B16AA41EF7FA65ED538ECBE895F/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Current Issues in Depression in Parkinson's Disease</title>
</titleStmt>
<publicationStmt><authority>ISTEX</authority>
<publisher>ELSEVIER</publisher>
<availability><p>ELSEVIER</p>
</availability>
<date>1999</date>
</publicationStmt>
<notesStmt><note type="content">Section title: Special Articles</note>
</notesStmt>
<sourceDesc><biblStruct type="inbook"><analytic><title level="a">Current Issues in Depression in Parkinson's Disease</title>
<author><persName><forename type="first">Theresa A.</forename>
<surname>Zesiewicz</surname>
</persName>
<roleName type="degree">M.D.</roleName>
<affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</affiliation>
</author>
<author><persName><forename type="first">Michael</forename>
<surname>Gold</surname>
</persName>
<roleName type="degree">M.D.</roleName>
<affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</affiliation>
</author>
<author><persName><forename type="first">Ganesh</forename>
<surname>Chari</surname>
</persName>
<roleName type="degree">M.D.</roleName>
<affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</affiliation>
</author>
<author><persName><forename type="first">Robert A.</forename>
<surname>Hauser</surname>
</persName>
<roleName type="degree">M.D.</roleName>
<affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</affiliation>
</author>
</analytic>
<monogr><title level="j">The American Journal of Geriatric Psychiatry</title>
<title level="j" type="abbrev">AMGP</title>
<idno type="pISSN">1064-7481</idno>
<idno type="PII">S1064-7481(12)X6099-8</idno>
<imprint><publisher>ELSEVIER</publisher>
<date type="published" when="1998"></date>
<biblScope unit="volume">7</biblScope>
<biblScope unit="issue">2</biblScope>
<biblScope unit="page" from="110">110</biblScope>
<biblScope unit="page" to="118">118</biblScope>
</imprint>
</monogr>
<idno type="istex">437EFFEF2C350B16AA41EF7FA65ED538ECBE895F</idno>
<idno type="DOI">10.1097/00019442-199905000-00003</idno>
<idno type="PII">S1064-7481(12)61204-4</idno>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><creation><date>1999</date>
</creation>
<langUsage><language ident="en">en</language>
</langUsage>
<abstract><p>Depression affects 4050 of Parkinson's disease (PD) patients. The authors, by use of a Mednet and manual search of pertinent literature, summarize current issues in the treatment of depression in PD. Open-label studies suggest that antidepressants may be effective for treating depression in PD. Although case reports indicate that selective serotonin reuptake inhibitors (SSRIs) can potentially worsen the motor symptoms of PD, this effect has not been confirmed in the small number of open-label studies that have been performed to date. The occurrence of the serotonin syndrome resulting from a combination of selegiline and an SSRI appears to be rare. Double-blind prospective studies are needed to evaluate the safety and efficacy of antidepressants in PD and their effect on motor function.</p>
</abstract>
</profileDesc>
<revisionDesc><change when="1998-06-22">Registration</change>
<change when="1998-06-02">Modified</change>
<change when="1998">Published</change>
</revisionDesc>
</teiHeader>
</istex:fulltextTEI>
</fulltext>
<metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration>
<istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.1.0//EN//XML" URI="art510.dtd" name="istex:docType"></istex:docType>
<istex:document><article docsubtype="fla"> <item-info> <jid>AMGP</jid>
 <aid>61204</aid>
 <ce:pii>S1064-7481(12)61204-4</ce:pii>
 <ce:doi>10.1097/00019442-199905000-00003</ce:doi>
 <ce:copyright type="society" year="1999">American Association for Geriatric Psychiatry</ce:copyright>
 </item-info>
 <head> <ce:dochead> <ce:textfn>Special Articles</ce:textfn>
 </ce:dochead>
 <ce:title>Current Issues in Depression in Parkinson's Disease</ce:title>
 <ce:author-group> <ce:author> <ce:given-name>Theresa A.</ce:given-name>
 <ce:surname>Zesiewicz</ce:surname>
 <ce:degrees>M.D.</ce:degrees>
 </ce:author>
 <ce:author> <ce:given-name>Michael</ce:given-name>
 <ce:surname>Gold</ce:surname>
 <ce:degrees>M.D.</ce:degrees>
 </ce:author>
 <ce:author> <ce:given-name>Ganesh</ce:given-name>
 <ce:surname>Chari</ce:surname>
 <ce:degrees>M.D.</ce:degrees>
 </ce:author>
 <ce:author> <ce:given-name>Robert A.</ce:given-name>
 <ce:surname>Hauser</ce:surname>
 <ce:degrees>M.D.</ce:degrees>
<ce:cross-ref refid="cor1"><ce:sup>*</ce:sup>
</ce:cross-ref>
 </ce:author>
 <ce:affiliation> <ce:textfn>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</ce:textfn>
 </ce:affiliation>
 <ce:correspondence id="cor1"> <ce:label>*</ce:label>
 <ce:text>Address correspondence to Dr. Hauser, Parkinson's Disease and Movement Disorders Center, University of South Florida College of Medicine, 4 Columbia Drive, Suite 410, Tampa, FL 33606</ce:text>
 </ce:correspondence>
 </ce:author-group>
 <ce:date-received day="20" month="2" year="1998"></ce:date-received>
 <ce:date-revised day="2" month="6" year="1998"></ce:date-revised>
 <ce:date-accepted day="22" month="6" year="1998"></ce:date-accepted>
 <ce:abstract> <ce:abstract-sec> <ce:simple-para id="spara10">Depression affects 40%–50% of Parkinson's disease (PD) patients. The authors, by use of a Mednet and manual search of pertinent literature, summarize current issues in the treatment of depression in PD. Open-label studies suggest that antidepressants may be effective for treating depression in PD. Although case reports indicate that selective serotonin reuptake inhibitors (SSRIs) can potentially worsen the motor symptoms of PD, this effect has not been confirmed in the small number of open-label studies that have been performed to date. The occurrence of the serotonin syndrome resulting from a combination of selegiline and an SSRI appears to be rare. Double-blind prospective studies are needed to evaluate the safety and efficacy of antidepressants in PD and their effect on motor function.</ce:simple-para>
 </ce:abstract-sec>
 </ce:abstract>
 </head>
 <body> <ce:sections> <ce:para id="para10">Depression is a common and potentially debilitating aspect of Parkinson's disease (PD),<ce:cross-ref refid="bib1"><ce:sup>1</ce:sup>
</ce:cross-ref>
 affecting approximately 40%–50% of patients.<ce:cross-refs refid="bib2 bib3"><ce:sup>2,3</ce:sup>
</ce:cross-refs>
 Although the exact etiology of depression in PD is unclear, evidence suggests that biochemical changes, psychosocial factors, and situational stressors may all contribute to its development.<ce:cross-refs refid="bib2 bib4 bib5"><ce:sup>2,4,5</ce:sup>
</ce:cross-refs>
 Regardless of cause, depression adversely affects quality of life.<ce:cross-ref refid="bib6"><ce:sup>6</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para20">The selective serotonin reuptake inhibitor (SSRI) antidepressants have recently gained widespread popularity because of their low incidence of serious side effects and convenient once-a-day dosing.<ce:cross-refs refid="bib7 bib8"><ce:sup>7,8</ce:sup>
</ce:cross-refs>
 However, there is currently little information available regarding either their safety and efficacy for treating depression in PD or their effect on motor function. Another consideration is that SSRIs, as well as other antidepressants, have been reported to interact with selegiline, a monoamine oxidase (MAO) inhibitor used in the treatment of PD, to cause the serotonin syndrome. This syndrome may be related to excessive serotonergic stimulation<ce:cross-ref refid="bib9"><ce:sup>9</ce:sup>
</ce:cross-ref>
 and is composed of a constellation of clinical signs, including mental status changes, myoclonus, diaphoresis, hyperreflexia, tremor, diarrhea, shivering, incoordination, and fever.<ce:cross-ref refid="bib9"><ce:sup>9</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para30">The relative lack of information regarding treatment of depression in PD warrants a review of available literature to guide current treatment and define the need for future clinical trials. In this article, we review current issues regarding depression in PD and discuss available treatment options.</ce:para>
 <ce:section id="cesec10"> <ce:section id="cesec20"> <ce:section-title>Diagnosis and Assessment of Depression in Parkinson's Disease</ce:section-title>
 <ce:para id="para40">Diagnostic and Statistical Manual (DSM) criteria can be used to diagnose and classify depression in PD. DSM-IV<ce:cross-ref refid="bib10"><ce:sup>10</ce:sup>
</ce:cross-ref>
 criteria technically exclude a diagnosis of major depression or dysthymic disorder in PD because the depression is “associated with a medical condition.”<ce:cross-ref refid="bib10"><ce:sup>10</ce:sup>
</ce:cross-ref>
 Nonetheless, the remaining DSM criteria can be used to evaluate and classify the depression and we make note that the depression is present in association with PD. These criteria are widely accepted and provide a standardized method of evaluation.<ce:cross-ref refid="bib11"><ce:sup>11</ce:sup>
</ce:cross-ref>
 However, up to 50% of PD patients with depressive symptoms do not meet DSM criteria for major depression or dysthymia,<ce:cross-ref refid="bib12"><ce:sup>12</ce:sup>
</ce:cross-ref>
 and many of these patients may meet criteria for “subsyndromal symptomatic depression.”<ce:cross-refs refid="bib12 bib13"><ce:sup>12,13</ce:sup>
</ce:cross-refs>
</ce:para>
 <ce:para id="para50">Depression can be quantified by use of clinical rating scales, including the Beck Depression Inventory (BDI),<ce:cross-ref refid="bib14"><ce:sup>14</ce:sup>
</ce:cross-ref>
 the Minnesota Multiphasic Personality Inventory,<ce:cross-ref refid="bib15"><ce:sup>15</ce:sup>
</ce:cross-ref>
 the Hamilton Rating Scale for Depression (Ham-D),<ce:cross-ref refid="bib16"><ce:sup>16</ce:sup>
</ce:cross-ref>
 the Montgomery-Asperg Scale,<ce:cross-ref refid="bib17"><ce:sup>17</ce:sup>
</ce:cross-ref>
 the Zung rating scale,<ce:cross-ref refid="bib18"><ce:sup>18</ce:sup>
</ce:cross-ref>
 and the Geriatric Depression Scale.<ce:cross-ref refid="bib19"><ce:sup>19</ce:sup>
</ce:cross-ref>
 The validity of these scales for PD patients has been questioned, with concern that clinical symptoms of depression might overlap with or be mistaken for those of PD. For example, the BDI contains somatic items pertaining to physical appearance, ability to work, fatigue, and concern about health, which could be attributed either to depression or PD. However, Levin et al.<ce:cross-ref refid="bib20"><ce:sup>20</ce:sup>
</ce:cross-ref>
 confirmed that somatic items on the BDI did not detract from its reliability and validity in measuring depression in PD. Similar evaluations of other depression scales have not yet been performed.</ce:para>
 <ce:para id="para60">Major depression in PD is qualitatively different from primary major depression in that it involves less self-blame, guilt, delusions, and sense of failure.<ce:cross-refs refid="bib21 bib22"><ce:sup>21,22</ce:sup>
</ce:cross-refs>
 Depressed PD patients also harbor self-destructive thoughts less frequently than patients with primary depression.<ce:cross-ref refid="bib21"><ce:sup>21</ce:sup>
</ce:cross-ref>
</ce:para>
 </ce:section>
 <ce:section id="cesec30"> <ce:section-title>Depression and Motor Disability</ce:section-title>
 <ce:para id="para70">There is no consistent relationship between the severity of depression and the degree of physical impairment or functional disability from parkinsonian symptoms.<ce:cross-refs refid="bib23 bib24 bib25 bib26"><ce:sup>23–26</ce:sup>
</ce:cross-refs>
 The few studies reporting a link between overall motor disability and depressive symptoms tend to rely on patient self-ratings,<ce:cross-ref refid="bib27"><ce:sup>27</ce:sup>
</ce:cross-ref>
 rather than standardized clinical evaluations.<ce:cross-ref refid="bib28"><ce:sup>28</ce:sup>
</ce:cross-ref>
 Also, many early studies used nonstandard methods of defining and quantifying depression and disability. More comprehensive studies, using standardized measures, have generally failed to identify a clear association between the two.<ce:cross-ref refid="bib28"><ce:sup>28</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para80">Studies of PD patients suggest that depressive symptoms often precede those of motor dysfunction. Mjones<ce:cross-ref refid="bib29"><ce:sup>29</ce:sup>
</ce:cross-ref>
 observed that PD patients often demonstrate prodromal symptoms of depression that persist through the onset of motor signs. Other retrospective studies also indicate that depressive symptoms commonly occur before motor signs, with prevalence rates ranging from 12% to 37%.<ce:cross-refs refid="bib28 bib30"><ce:sup>28,30</ce:sup>
</ce:cross-refs>
</ce:para>
 <ce:para id="para90">Once motor symptoms emerge, there may be a nonlinear relationship of depressive symptoms to stage of disease. Two clinical studies have found depression to be most common in Hoehn and Yahr Stages I, III, and IV.<ce:cross-refs refid="bib24 bib26"><ce:sup>24,26</ce:sup>
</ce:cross-refs>
 It is unclear whether this observation represents a consistent triphasic pattern or whether methodology, such as sampling technique, could explain such findings.<ce:cross-ref refid="bib31"><ce:sup>31</ce:sup>
</ce:cross-ref>
</ce:para>
 </ce:section>
 <ce:section id="cesec40"> <ce:section-title>Anxiety in Parkinson's Disease</ce:section-title>
 <ce:para id="para100">The incidence of anxiety in PD appears to be higher than that in the general population. Whereas the incidence of an anxiety disorder in the general population ranges from 5% to 15%, the incidence in PD may be as high as 38%.<ce:cross-ref refid="bib32"><ce:sup>32</ce:sup>
</ce:cross-ref>
 Also, the incidence of anxiety in PD is higher than that in other chronic medical conditions, including multiple sclerosis.<ce:cross-refs refid="bib33 bib34"><ce:sup>33,34</ce:sup>
</ce:cross-refs>
 Anxiety in PD has not been found to correlate with the severity of motor symptoms.<ce:cross-ref refid="bib32"><ce:sup>32</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para110">Surveys indicate that some PD patients develop anxiety before they develop motor signs.<ce:cross-ref refid="bib32"><ce:sup>32</ce:sup>
</ce:cross-ref>
 Henderson et al.<ce:cross-ref refid="bib35"><ce:sup>35</ce:sup>
</ce:cross-ref>
 surveyed 164 PD patients and found that 78 experienced symptoms of panic or anxiety. Of these, 21% had symptoms of panic/anxiety before the onset of motor symptoms; 23% experienced panic/anxiety and PD concurrently; and 66% developed panic/anxiety after the onset of PD.</ce:para>
 <ce:para id="para120">The relationship between anxiety and antiparkinsonian medications is controversial. One study found no relationship between anxiety and the levodopa dose or the cumulative duration of levodopa exposure.<ce:cross-ref refid="bib32"><ce:sup>32</ce:sup>
</ce:cross-ref>
 In contrast, Vasquez et al.<ce:cross-ref refid="bib36"><ce:sup>36</ce:sup>
</ce:cross-ref>
 observed that patients suffering from panic attacks had been started on levodopa earlier and required higher doses than PD patients without panic attacks.</ce:para>
 <ce:para id="para130">Depression and anxiety frequently coexist in PD.<ce:cross-ref refid="bib35"><ce:sup>35</ce:sup>
</ce:cross-ref>
 Menza et al.<ce:cross-ref refid="bib34"><ce:sup>34</ce:sup>
</ce:cross-ref>
 found that 12 of 42 PD patients met DSM criteria for an anxiety disorder. Eleven (92%) of these patients had a comorbid depressive disorder.</ce:para>
 </ce:section>
 <ce:section id="cesec50"> <ce:section-title>Dementia and Depression in Parkinson's Disease</ce:section-title>
 <ce:para id="para140">Depression and dementia co-exist in a significant number of patients with PD.<ce:cross-ref refid="bib37"><ce:sup>37</ce:sup>
</ce:cross-ref>
 In a large-scale community-based survey of dementia in PD, dementia was detected in 27% of patients.<ce:cross-ref refid="bib38"><ce:sup>38</ce:sup>
</ce:cross-ref>
 Patients with dementia had a significantly higher prevalence of major depression (23%) than PD patients without dementia (2.3%). In a case-control study of patients with PD and dementia with or without depression, significant cognitive impairments were detected in both PD groups compared with normal-control subjects.<ce:cross-ref refid="bib39"><ce:sup>39</ce:sup>
</ce:cross-ref>
 After PD patients were matched for disease severity, patients with co-existing depression were found to be significantly more impaired in confrontation naming and lexical and semantic fluency than nondepressed PD patients. The authors concluded that depression might exacerbate the cognitive impairments of PD but did not influence its qualitative features. In a prospective cohort study of non-dementia patients with PD, 19.2% developed dementia over a period of 2 years.<ce:cross-ref refid="bib40"><ce:sup>40</ce:sup>
</ce:cross-ref>
 The coexistence of depressive features (Ham-D>10) was associated with a significantly increased risk of developing dementia.</ce:para>
 <ce:para id="para150">How much of the apparent overlap between depression and dementia might be due to the confounding negative effects of depression on cognitive performance is unknown. Some cognitive tasks are unaffected in depressed PD patients<ce:cross-ref refid="bib41"><ce:sup>41</ce:sup>
</ce:cross-ref>
 and may provide a tool to dissociate the effects of depression and dementia on cognitive performance.</ce:para>
 <ce:para id="para160">Diffuse Lewy-body disease (DLBD) is a recently recognized disorder marked pathologically by loss of nigrostriatal dopamine neurons and Lewy bodies in both the midbrain and the cortex.<ce:cross-ref refid="bib42"><ce:sup>42</ce:sup>
</ce:cross-ref>
 Clinically, patients exhibit parkinsonism and cognitive/psychiatric changes, although the full clinical spectrum is still being defined. Premortem diagnosis may be difficult, and it is unclear how many patients clinically diagnosed with PD actually have DLBD. DLBD patients have a higher incidence of dementia than PD patients and experience cognitive decline sooner. It is not clear how the contamination of studies of PD patients with DLBD patients affects estimates of dementia and depression in PD.<ce:cross-ref refid="bib43"><ce:sup>43</ce:sup>
</ce:cross-ref>
 At least one retrospective study found no difference in the frequency of depression in DLBD and PD.<ce:cross-ref refid="bib44"><ce:sup>44</ce:sup>
</ce:cross-ref>
</ce:para>
 </ce:section>
 <ce:section id="cesec60"> <ce:section-title>Neurochemistry of Depression in PD</ce:section-title>
 <ce:para id="para170">It is not known whether the etiology of depression in PD is endogenous, reactive, or both. Because neither functional disability nor disease duration has been consistently associated with depression in PD, a simple reactive model appears unlikely. The occurrence of depression in 12%–37% of patients shortly before the appearance of motor symptoms argues for a biochemical etiology.<ce:cross-ref refid="bib28"><ce:sup>28</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para180">In the 1950s, affective disorders were found to be associated with changes in brain catecholamine metabolism.<ce:cross-refs refid="bib45 bib46 bib47"><ce:sup>45–47</ce:sup>
</ce:cross-refs>
 Depression was linked to a relative deficiency of catecholamines, primarily norepinephrine, and first-generation antidepressants were found to enhance serotonin, noradrenaline,<ce:cross-ref refid="bib48"><ce:sup>48</ce:sup>
</ce:cross-ref>
 and, to a lesser extent, dopamine.<ce:cross-ref refid="bib49"><ce:sup>49</ce:sup>
</ce:cross-ref>
 A reduction of all three catecholamines was identified in PD patients,<ce:cross-ref refid="bib50"><ce:sup>50</ce:sup>
</ce:cross-ref>
 sparking interest in the aminergic hypothesis for depression in PD. Several studies identified decreased cerebrospinal fluid 5-hydroxy-indoleacetic acid (5-HIAA) levels in depressed PD patients,<ce:cross-refs refid="bib51 bib52 bib53"><ce:sup>51–53</ce:sup>
</ce:cross-refs>
 whereas others failed to replicate these findings.<ce:cross-ref refid="bib54"><ce:sup>54</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para190">Evidence of a dopaminergic mechanism in human mood dysregulation has been elusive. The ventral tegmentum is thought to be involved in modulating reward systems,<ce:cross-ref refid="bib55"><ce:sup>55</ce:sup>
</ce:cross-ref>
 and experimental lesions of dopaminergic pathways outside the striatum have been implicated in neuropsychiatric disorders.<ce:cross-ref refid="bib56"><ce:sup>56</ce:sup>
</ce:cross-ref>
 Torack and Morris<ce:cross-ref refid="bib57"><ce:sup>57</ce:sup>
</ce:cross-ref>
 identified dopaminergic depletion in the ventral tegmental area (VTA) at autopsy in several depressed PD patients. Afferents from the VTA project to the orbital and prefrontal cortices,<ce:cross-refs refid="bib58 bib59"><ce:sup>58,59</ce:sup>
</ce:cross-refs>
 regions found to be hypometabolic on 2-[18-F]-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in depressed PD patients.<ce:cross-ref refid="bib60"><ce:sup>60</ce:sup>
</ce:cross-ref>
 Although abnormalities in dopaminergic pathways may play a role in the pathogenesis of depression, levodopa has not consistently been found to alleviate depressive symptoms.<ce:cross-ref refid="bib61"><ce:sup>61</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para200">It seems likely that the etiology of depression in PD encompasses a variety of factors, including both biochemical changes and psychosocial issues. Serotonergic, and to a lesser extent dopaminergic, changes are probably important contributors to depression in a substantial proportion of PD patients.</ce:para>
 </ce:section>
 </ce:section>
 <ce:section id="cesec70"> <ce:section-title>TREATMENT OF DEPRESSION IN PD</ce:section-title>
 <ce:section id="cesec80"> <ce:section-title>Tricyclic Antidepressants</ce:section-title>
 <ce:para id="para210">Tricyclic antidepressants have been found, in a limited number of studies,<ce:cross-refs refid="bib33 bib62 bib63"><ce:sup>33,62,63</ce:sup>
</ce:cross-refs>
 to improve depression in PD patients, and some have suggested that they might also improve parkinsonian motor symptoms.<ce:cross-refs refid="bib62 bib63"><ce:sup>62,63</ce:sup>
</ce:cross-refs>
 Laitinen<ce:cross-ref refid="bib63"><ce:sup>63</ce:sup>
</ce:cross-ref>
 performed a double-blind, placebo-controlled study to determine the effects of desipramine in 39 depressed PD patients requiring additional antiparkinsonian medication. Desipramine improved depression, tremor, and rigidity. In contrast, Andersen et al.<ce:cross-ref refid="bib33"><ce:sup>33</ce:sup>
</ce:cross-ref>
 performed a double-blind, placebo-controlled crossover trial of nortriptyline in 19 depressed PD patients who were optimally treated with levodopa/carbidopa (Sinemet). Nortriptyline provided significant benefit for depression, and no changes were observed in motor signs. Another study evaluated the effect of imipramine in nondepressed PD patients after all antiparkinsonian medications were discontinued for 3 days.<ce:cross-ref refid="bib64"><ce:sup>64</ce:sup>
</ce:cross-ref>
 Improvement in salivation and rigidity was observed in five of eight patients.</ce:para>
 <ce:para id="para220">Design methodology limits the conclusions that can be drawn from these early studies because many relied on observation rather than clinical rating scales to document changes in depression and motor function.<ce:cross-refs refid="bib62 bib64"><ce:sup>62,64</ce:sup>
</ce:cross-refs>
 Also, control of motor disability at baseline varied from study to study. In general, patients whose parkinsonian motor features were suboptimally treated experienced improvement in these symptoms,<ce:cross-refs refid="bib63 bib64"><ce:sup>63,64</ce:sup>
</ce:cross-refs>
 whereas motor improvement was not observed in patients whose parkinsonian symptoms were well controlled with levodopa.<ce:cross-ref refid="bib33"><ce:sup>33</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para230">Tricyclic antidepressant-induced improvement of motor symptoms in PD may be mediated through either anticholinergic or dopaminergic mechanisms.<ce:cross-refs refid="bib65 bib66 bib67"><ce:sup>65–67</ce:sup>
</ce:cross-refs>
 Improvement in tremor and salivation may be due to anticholinergic effects.<ce:cross-ref refid="bib64"><ce:sup>64</ce:sup>
</ce:cross-ref>
 In contrast, it seems unlikely that improvement in rigidity can be attributed to anticholinergic activity. Ghosh and Hrdina<ce:cross-ref refid="bib66"><ce:sup>66</ce:sup>
</ce:cross-ref>
 observed an increase in striatal dopamine concentration in rats after intraperitoneal administration of desipramine, imipramine, or amitriptyline. All three antidepressants produced a marked increase in striatal dopamine at 1 hour. The effect of desipramine was biphasic, with an initial increase in dopamine concentration at 1 hour followed by a decrease at 3 hours. Another study reported that rats injected with imipramine and sacrificed at 6 hours exhibited an increase in dopamine concentration in the pons, medulla, and cerebellum, but a decrease in dopamine concentration in the striatum.<ce:cross-ref refid="bib68"><ce:sup>68</ce:sup>
</ce:cross-ref>
 Tricyclic antidepressants have also been found to inhibit the uptake of dopamine.<ce:cross-ref refid="bib67"><ce:sup>67</ce:sup>
</ce:cross-ref>
 Thus, the effects of tricyclic antidepressants on striatal dopamine activity appear to be complex and time-dependent. It is unclear to what extent tricyclic-induced changes in striatal dopamine concentration might affect motor disability.</ce:para>
 </ce:section>
 <ce:section id="cesec90"> <ce:section-title>Selective Serotonin Reuptake Inhibitors (SSRIs) and Atypical Antidepressants</ce:section-title>
 <ce:para id="para240">Few reported studies have examined the clinical effects of SSRIs and atypical antidepressants in PD. A recent open-label pilot evaluation of the safety and efficacy of sertraline for the treatment of depression in PD found improvement in BDI scores and no change in motor function as assessed by the Unified Parkinson's Disease Rating Scale (UPDRS).<ce:cross-ref refid="bib69"><ce:sup>69</ce:sup>
</ce:cross-ref>
 Similarly, another open-label study found that sertraline reduced depression in PD patients and had no effect on motor scores.<ce:cross-ref refid="bib70"><ce:sup>70</ce:sup>
</ce:cross-ref>
 A 2-year, open-label study evaluating the safety and efficacy of paroxetine found that 85% of treated depressed PD patients experienced a reduction in depressive symptoms.<ce:cross-ref refid="bib71"><ce:sup>71</ce:sup>
</ce:cross-ref>
 In another study, bupropion improved mood in 5 of 12 depressed PD patients, and motor symptoms improved significantly, with the greatest benefit for gait and akinesia.<ce:cross-ref refid="bib72"><ce:sup>72</ce:sup>
</ce:cross-ref>
</ce:para>
 </ce:section>
 <ce:section id="cesec100"> <ce:section-title>Do SSRIs Exacerbate Parkinsonian Symptoms?</ce:section-title>
 <ce:para id="para250">Several case reports suggest that SSRIs can aggravate the motor signs of PD. An increase in parkinsonian motor disability was noted in four patients with idiopathic PD after exposure to fluoxetine.<ce:cross-ref refid="bib73"><ce:sup>73</ce:sup>
</ce:cross-ref>
 In all patients, antiparkinsonian medication consisted of levodopa and amantadine only. Fluoxetine dosage was 20 mg/day and was given to the patients for at least 8 weeks, with a maximum of 11 weeks. Parkinsonian disability worsened, as evidenced by substantial increases in UPDRS scores. Fluoxetine was withdrawn from all patients, and UPDRS scores returned to previous values within 4 weeks.</ce:para>
 <ce:para id="para260">Another 64-year-old depressed PD patient experienced exacerbation of tremor in the left upper and lower extremities while receiving fluoxetine 20 mg/day.<ce:cross-ref refid="bib74"><ce:sup>74</ce:sup>
</ce:cross-ref>
 Also, a 35-year-old woman with PD and depression developed exacerbation of masked facies, tremor, rigidity, and postural instability after taking paroxetine 20 mg/day. Parkinsonian symptoms returned to baseline 2 months after paroxetine was discontinued.<ce:cross-ref refid="bib75"><ce:sup>75</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para270">Some non-PD patients have been reported to experience parkinsonism induced by an SSRI. One correspondence noted extrapyramidal signs in 5 of 28 nonparkinsonian patients treated with fluoxetine for major depression in doses ranging from 20 mg to 60 mg/day.<ce:cross-ref refid="bib76"><ce:sup>76</ce:sup>
</ce:cross-ref>
 Within 2 weeks after withdrawal of fluoxetine, parkinsonian symptoms improved. One patient had received previous haloperidol therapy, which caused mild parkinsonism before fluoxetine treatment. In another report, a 39-year-old woman with bipolar affective disease whose symptoms were controlled with haloperidol developed parkinsonism (cogwheel rigidity and masked facies) and akathisia after 2 weeks on fluoxetine.<ce:cross-ref refid="bib77"><ce:sup>77</ce:sup>
</ce:cross-ref>
 Extrapyramidal symptoms resolved after fluoxetine was discontinued, and the patient was later started on perphenazine without further parkinsonian side effects. One patient with major depression and cerebral palsy who had been treated with haloperidol for a myoclonic disorder developed severe, generalized stiffness in her arms, legs, and back with the addition of fluoxetine 20 mg/day. Stiffness resolved with the removal of fluoxetine.<ce:cross-ref refid="bib78"><ce:sup>78</ce:sup>
</ce:cross-ref>
 A chronically depressed woman treated with lithium and clonazepam was started on fluoxetine 20 mg/day and received up to 40 mg/day. She subsequently developed hand tremor, ataxia, and stumbling gait, and fluoxetine was discontinued.<ce:cross-ref refid="bib79"><ce:sup>79</ce:sup>
</ce:cross-ref>
 Another case report documented the onset of parkinsonism in a patient treated with fluoxetine after the introduction of cimetidine.<ce:cross-ref refid="bib80"><ce:sup>80</ce:sup>
</ce:cross-ref>
 One chronically depressed patient previously treated with neuroleptics developed an akinetic-rigid syndrome while receiving fluvoxamine.<ce:cross-ref refid="bib81"><ce:sup>81</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para280">Clinical trials in PD populations have not identified worsening of extrapyramidal symptoms with antidepressant use. Two open-label studies examining the efficacy of sertraline in treating depression in PD did not identify worsening of parkinsonian signs.<ce:cross-refs refid="bib69 bib70"><ce:sup>69,70</ce:sup>
</ce:cross-refs>
 In another trial, no changes in rigidity or bradykinesia were identified in 14 nondepressed PD patients treated with fluoxetine for 1 month.<ce:cross-ref refid="bib82"><ce:sup>82</ce:sup>
</ce:cross-ref>
 A retrospective chart review of depressed PD patients treated with fluoxetine also found no worsening of parkinsonism.<ce:cross-ref refid="bib83"><ce:sup>83</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para290">It is therefore unclear whether SSRIs have a negative effect on motor signs in PD. Some patients have been reported to worsen, but these cases represent a very small percentage of PD patients who have been treated with SSRIs. Definitive evidence of a negative effect on motor signs is lacking because case reports are subject to open-label assessment and ascertainment bias. Fluoxetine is the SSRI most commonly reported to cause worsening of motor features of PD, but it has also been available for the longest time. In contrast, we are not aware of any reports of sertraline causing an exacerbation of PD features. It is also noteworthy that many of the patients reported to experience extrapyramidal side effects from SSRIs were either currently receiving or had been on neuroleptics.</ce:para>
 </ce:section>
 <ce:section id="cesec110"> <ce:section-title>The Serotonin Syndrome</ce:section-title>
 <ce:para id="para300">SSRIs, either alone or in combination with selegiline, can cause the serotonin syndrome. The mechanism underlying the serotonin syndrome may be related to enhanced stimulation of 5-HIAA receptors in the brainstem and spinal cord.<ce:cross-ref refid="bib9"><ce:sup>9</ce:sup>
</ce:cross-ref>
 Proposed criteria for the diagnosis include the presence of at least three of the following: mental status changes, myoclonus, diaphoresis, hyperreflexia, tremor, diarrhea, shivering, incoordination, and fever.<ce:cross-ref refid="bib77"><ce:sup>77</ce:sup>
</ce:cross-ref>
 Some patients experience seizures or coma; others have died.<ce:cross-ref refid="bib84"><ce:sup>84</ce:sup>
</ce:cross-ref>
 The complication of arterial hypertension has also been reported with the concomitant use of fluoxetine and selegiline,<ce:cross-refs refid="bib85 bib86"><ce:sup>85,86</ce:sup>
</ce:cross-refs>
 although it is unclear whether this is part of the serotonin syndrome.</ce:para>
 <ce:para id="para310">Serotonin syndrome due to a combination of selegiline and an antidepressant appears to be rare. Two chart reviews of patients who received a combination of SSRIs and selegiline failed to detect side effects that had not already been reported with each respective medication alone.<ce:cross-refs refid="bib87 bib88"><ce:sup>87,88</ce:sup>
</ce:cross-refs>
 Investigators of the Parkinson Study Group were surveyed as to their experience with the combined use of selegiline and antidepressants. Of 4,568 patients treated with this combination of medications, only 0.24% reported symptoms that were thought to be consistent with the serotonin syndrome, and only 0.04% experienced symptoms that were serious in nature.<ce:cross-ref refid="bib89"><ce:sup>89</ce:sup>
</ce:cross-ref>
 Thus, current information indicates that serious interactions between selegiline (at oral doses of 5 mg bid or less) and antidepressants are rare. It is possible that some patients may be at risk because of individual variations in metabolic pathways.</ce:para>
 </ce:section>
 <ce:section id="cesec120"> <ce:section-title>Selegiline and Depression</ce:section-title>
 <ce:para id="para320">Selegiline was initially designed as a “psychic energizer” consisting of an amphetamine moiety combined with an antidepressant-like compound.<ce:cross-ref refid="bib90"><ce:sup>90</ce:sup>
</ce:cross-ref>
 In early PD, selegiline delays the need for symptomatic therapy, and in advanced patients, improves motor function and reduces motor fluctuations in patients taking levodopa/carbidopa.<ce:cross-refs refid="bib91 bib92"><ce:sup>91,92</ce:sup>
</ce:cross-refs>
 As a relatively selective monoamine oxidase type B (MAO-B) inhibitor at oral doses of 10 mg per day or less, it is generally not associated with sympathomimetic crises caused by ingested tyramine or other monoamines (the “cheese effect”).<ce:cross-ref refid="bib93"><ce:sup>93</ce:sup>
</ce:cross-ref>
 Because levodopa/carbidopa can induce sympathomimetic crises when gut MAO-A is inhibited, PD patients are usually restricted to oral selegiline doses of 10 mg/day or less. At these doses, selegiline does not appear to exert an antidepressant effect.<ce:cross-ref refid="bib94"><ce:sup>94</ce:sup>
</ce:cross-ref>
</ce:para>
 <ce:para id="para330">Mania may be an uncommon effect of selegiline. Boyson observed hypomania or mania in four young female PD patients on selegiline at a dose of 5 mg bid. Two of these women had a history compatible with cyclothymia. Symptoms improved when the selegiline dose was lowered to 2.5 mg–5 mg per day.<ce:cross-ref refid="bib95"><ce:sup>95</ce:sup>
</ce:cross-ref>
 It was suggested that selegiline be prescribed cautiously in patients with cyclothymia.</ce:para>
 <ce:para id="para340">One study has suggested that selegiline may increase mortality in PD patients. The Parkinson's Disease Research Group of the United Kingdom reported a 57% higher mortality rate in patients assigned to levodopa combined with selegiline than to levodopa alone in an open, long-term prospective trial.<ce:cross-ref refid="bib96"><ce:sup>96</ce:sup>
</ce:cross-ref>
 Several substantive issues have been raised regarding the methodology and results of this study. Both treatment groups had unusually high mortality rates (selegiline: 28%; non-selegiline: 18%), and there was an apparent lack of appropriate statistical adjustment for interim analyses.<ce:cross-ref refid="bib97"><ce:sup>97</ce:sup>
</ce:cross-ref>
 Also, the difference in mortality was not statistically significant when groups were analyzed according to the medications patients were actually taking. It is therefore unclear whether the conclusions of this study are valid.</ce:para>
 <ce:para id="para350">Selegiline may be effective in treating primary depression in oral doses of 30 mg–40 mg/day, likely owing to MAO-A inhibition.<ce:cross-ref refid="bib98"><ce:sup>98</ce:sup>
</ce:cross-ref>
 Selective inhibition of MAO-A, but not MAO-B, has been shown to result in an antidepressant-like effect in rats.<ce:cross-ref refid="bib99"><ce:sup>99</ce:sup>
</ce:cross-ref>
 A double-blind, placebo-controlled study evaluating the effect of selegiline in patients with primary depression found that depression was unchanged after 3 weeks at 10 mg per day, but significantly improved after 6 weeks at 30 mg per day.<ce:cross-ref refid="bib94"><ce:sup>94</ce:sup>
</ce:cross-ref>
 Another study reported no significant effect at doses of 20 mg/day administered for 3 weeks.<ce:cross-ref refid="bib100"><ce:sup>100</ce:sup>
</ce:cross-ref>
 There is now interest in whether the transdermal, sublingual, or intranasal delivery of selegiline would be useful in the treatment of depression. These delivery formulations might allow sufficient MAO-A inhibition in the brain to improve depression without causing MAO-A inhibition in the gut that would require a tyramine-restricted diet. This therapy might also be safe for PD patients on levodopa/carbidopa.</ce:para>
 </ce:section>
 </ce:section>
 <ce:section id="cesec130"> <ce:section-title>CONCLUSION</ce:section-title>
 <ce:para id="para360">Depression and anxiety are common in PD and can have a profound negative impact on a patient's sense of well-being and functioning. The etiology of depression in PD probably encompasses both biochemical and psychosocial issues. PD patients should be routinely screened for the presence of depression and anxiety.</ce:para>
 <ce:para id="para370">Open-label studies suggest that antidepressants may be effective in treating depression in PD. SSRIs have a low incidence of serious adverse effects in primary depression and are widely used to treat depression in PD. Although case reports indicate that some patients experience a worsening of motor signs when SSRIs are introduced, this effect has not been confirmed in population studies. Also, many of the case studies documenting exacerbation of parkinsonism showed previous or concurrent neuroleptic use. The incidence of the serotonin syndrome attributable to SSRIs, either alone or in combination with selegiline, appears to be rare.</ce:para>
 <ce:para id="para380">Double-blind prospective clinical trials are needed to evaluate the safety and efficacy of antidepressants and their effect on motor signs in the treatment of depression and anxiety in PD. Patients enrolled in such studies should be evaluated for the presence of depression and anxiety by use of standardized clinical criteria and neuropsychiatric scales. Secondary evaluations should include an assessment of parkinsonian motor signs and adverse events, including the serotonin syndrome. Antidepressants should be studied at sufficient doses and over sufficient time to adequately evaluate their effects. We believe that antiparkinsonian medications should be held constant through such a study to evaluate any change in motor signs due to study medication. Because serious adverse effects due to the serotonin syndrome appear to be rare, it seems reasonable to include patients who are on selegiline at stable oral doses of 10 mg/day or less.</ce:para>
 </ce:section>
 </ce:sections>
 </body>
 <tail> <ce:bibliography id="bibl10"> <ce:section-title>References</ce:section-title>
 <ce:bibliography-sec id="cebibsec10"> <ce:bib-reference id="bib1"> <ce:label>1</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Mayeux</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Depression and dementia in Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:edited-book> <sb:editors> <sb:editor> <ce:given-name>CD</ce:given-name>
 <ce:surname>Marsden</ce:surname>
 </sb:editor>
 <sb:editor> <ce:given-name>S</ce:given-name>
 <ce:surname>Fahn</ce:surname>
 </sb:editor>
 </sb:editors>
 <sb:title> <sb:maintitle>Movement Disorders</sb:maintitle>
 </sb:title>
 <sb:date>1982</sb:date>
 <sb:publisher> <sb:name>Butterworth</sb:name>
 <sb:location>London, UK</sb:location>
 </sb:publisher>
 </sb:edited-book>
 <sb:pages> <sb:first-page>75</sb:first-page>
 <sb:last-page>95</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib2"> <ce:label>2</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Mayeux</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>Y</ce:given-name>
 <ce:surname>Stern</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JBW</ce:given-name>
 <ce:surname>Williams</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Clinical and biochemical features of depression in Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Am J Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>143</sb:volume-nr>
 </sb:series>
 <sb:date>1986</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>756</sb:first-page>
 <sb:last-page>759</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib3"> <ce:label>3</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>G</ce:given-name>
 <ce:surname>Doonief</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>E</ce:given-name>
 <ce:surname>Mirabello</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>K</ce:given-name>
 <ce:surname>Bell</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>An estimate of the incidence of depression in idiopathic Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>49</sb:volume-nr>
 </sb:series>
 <sb:date>1992</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>305</sb:first-page>
 <sb:last-page>307</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib4"> <ce:label>4</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>AM</ce:given-name>
 <ce:surname>Gotham</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>RG</ce:given-name>
 <ce:surname>Brown</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>CD</ce:given-name>
 <ce:surname>Marsden</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Depression in Parkinson's disease: a quantitative and qualitative analysis</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Neurol Neurosurg Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>49</sb:volume-nr>
 </sb:series>
 <sb:date>1986</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>381</sb:first-page>
 <sb:last-page>389</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib5"> <ce:label>5</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Mayeux</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>Y</ce:given-name>
 <ce:surname>Stern</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>L</ce:given-name>
 <ce:surname>Cote</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Altered serotonin metabolism in depressed patients with Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Neurology</sb:maintitle>
 </sb:title>
 <sb:volume-nr>34</sb:volume-nr>
 </sb:series>
 <sb:date>1984</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>642</sb:first-page>
 <sb:last-page>646</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib6"> <ce:label>6</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>VS</ce:given-name>
 <ce:surname>Kostic</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>SR</ce:given-name>
 <ce:surname>Filipovic</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>D</ce:given-name>
 <ce:surname>Lecic</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Effect of age at onset on frequency of depression in Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Neurol Neurosurg Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>57</sb:volume-nr>
 </sb:series>
 <sb:date>1994</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1265</sb:first-page>
 <sb:last-page>1267</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib7"> <ce:label>7</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>SH</ce:given-name>
 <ce:surname>Preskorn</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Recent pharmacologic advances in antidepressant therapy for the elderly</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Am J Med</sb:maintitle>
 </sb:title>
 <sb:volume-nr>94</sb:volume-nr>
 </sb:series>
 <sb:issue-nr>suppl 5A</sb:issue-nr>
 <sb:date>1993</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>2S</sb:first-page>
 <sb:last-page>12S</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib8"> <ce:label>8</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>SP</ce:given-name>
 <ce:surname>Roose</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>F</ce:given-name>
 <ce:surname>Laghrissi-Thode</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JS</ce:given-name>
 <ce:surname>Kennedy</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Comparison of paroxetine and nortriptyline in depressed patients with ischemic heart disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>JAMA</sb:maintitle>
 </sb:title>
 <sb:volume-nr>279</sb:volume-nr>
 </sb:series>
 <sb:date>1988</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>287</sb:first-page>
 <sb:last-page>291</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib9"> <ce:label>9</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>H</ce:given-name>
 <ce:surname>Sternbach</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>The serotonin syndrome</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Am J Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>148</sb:volume-nr>
 </sb:series>
 <sb:date>1991</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>705</sb:first-page>
 <sb:last-page>713</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib10"> <ce:label>10</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:surname>American Psychiatric Association</ce:surname>
 </sb:author>
 </sb:authors>
 </sb:contribution>
 <sb:host> <sb:book> <sb:title> <sb:maintitle>Diagnostic and Statistical Manual of Mental Disorders</sb:maintitle>
 </sb:title>
 <sb:edition>4th Edition</sb:edition>
 <sb:date>1994</sb:date>
 <sb:publisher> <sb:name>American Psychiatric Association</sb:name>
 <sb:location>Washington, DC</sb:location>
 </sb:publisher>
 </sb:book>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib11"> <ce:label>11</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Mayeux</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JBW</ce:given-name>
 <ce:surname>Williams</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>Y</ce:given-name>
 <ce:surname>Stern</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Depression and Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Adv Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>40</sb:volume-nr>
 </sb:series>
 <sb:date>1984</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>241</sb:first-page>
 <sb:last-page>250</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib12"> <ce:label>12</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>SE</ce:given-name>
 <ce:surname>Starkstein</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>TJ</ce:given-name>
 <ce:surname>Preziosi</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>PL</ce:given-name>
 <ce:surname>Bolduc</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Depression in Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Nerv Ment Dis</sb:maintitle>
 </sb:title>
 <sb:volume-nr>178</sb:volume-nr>
 </sb:series>
 <sb:date>1990</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>27</sb:first-page>
 <sb:last-page>31</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib13"> <ce:label>13</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>LL</ce:given-name>
 <ce:surname>Judd</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>MH</ce:given-name>
 <ce:surname>Rapaport</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>MP</ce:given-name>
 <ce:surname>Paulus</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Subsyndromal symptomatic depression: a new mood disorder?</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Clin Psych</sb:maintitle>
 </sb:title>
 <sb:volume-nr>55</sb:volume-nr>
 </sb:series>
 <sb:issue-nr>suppl</sb:issue-nr>
 <sb:date>1994</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>18</sb:first-page>
 <sb:last-page>28</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib14"> <ce:label>14</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>AT</ce:given-name>
 <ce:surname>Beck</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>CH</ce:given-name>
 <ce:surname>Ward</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>M</ce:given-name>
 <ce:surname>Mendelson</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>An inventory for measuring depression</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Gen Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>4</sb:volume-nr>
 </sb:series>
 <sb:date>1961</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>561</sb:first-page>
 <sb:last-page>571</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib15"> <ce:label>15</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>W</ce:given-name>
 <ce:surname>Dahlstrom</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>G</ce:given-name>
 <ce:surname>Welsh</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>L</ce:given-name>
 <ce:surname>Dahlstrom</ce:surname>
 </sb:author>
 </sb:authors>
 </sb:contribution>
 <sb:host> <sb:book> <sb:title> <sb:maintitle>An MMPI Handbook, Vol 1: Clinical Interpretation</sb:maintitle>
 </sb:title>
 <sb:date>1972</sb:date>
 <sb:publisher> <sb:name>University of Minnesota Press</sb:name>
 <sb:location>Minneapolis</sb:location>
 </sb:publisher>
 </sb:book>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib16"> <ce:label>16</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>M</ce:given-name>
 <ce:surname>Hamilton</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Development of a rating scale for primary depressive illness</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Br J Soc Clin Psychol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>6</sb:volume-nr>
 </sb:series>
 <sb:date>1967</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>278</sb:first-page>
 <sb:last-page>296</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib17"> <ce:label>17</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>SM</ce:given-name>
 <ce:surname>Montgomery</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Depressive symptoms in acute schizophrenia</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Prog Neuropsychopharmacol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>3</sb:volume-nr>
 </sb:series>
 <sb:date>1979</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>429</sb:first-page>
 <sb:last-page>433</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib18"> <ce:label>18</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>WWK</ce:given-name>
 <ce:surname>Zung</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>A self-rating depression scale</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Gen Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>12</sb:volume-nr>
 </sb:series>
 <sb:date>1965</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>63</sb:first-page>
 <sb:last-page>70</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib19"> <ce:label>19</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JA</ce:given-name>
 <ce:surname>Yesavage</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>TL</ce:given-name>
 <ce:surname>Brink</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>TL</ce:given-name>
 <ce:surname>Rose</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Development and validation of a geriatric depression screening scale: a preliminary report</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Psychiatr Res</sb:maintitle>
 </sb:title>
 <sb:volume-nr>17</sb:volume-nr>
 </sb:series>
 <sb:date>1982–83</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>37</sb:first-page>
 <sb:last-page>49</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib20"> <ce:label>20</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>BE</ce:given-name>
 <ce:surname>Levin</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>MM</ce:given-name>
 <ce:surname>Llabre</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>WJ</ce:given-name>
 <ce:surname>Weiner</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Parkinson's disease and depression: psychometric properties of the Beck Depression Inventory</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Neurol Neurosurg Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>51</sb:volume-nr>
 </sb:series>
 <sb:date>1988</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1401</sb:first-page>
 <sb:last-page>1404</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib21"> <ce:label>21</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>AT</ce:given-name>
 <ce:surname>Taylor</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JA</ce:given-name>
 <ce:surname>Saint-Cyr</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>AE</ce:given-name>
 <ce:surname>Lang</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Parkinson's disease and depression: a critical re-evaluation</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Brain</sb:maintitle>
 </sb:title>
 <sb:volume-nr>109</sb:volume-nr>
 </sb:series>
 <sb:date>1986</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>279</sb:first-page>
 <sb:last-page>292</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib22"> <ce:label>22</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>RG</ce:given-name>
 <ce:surname>Brown</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>B</ce:given-name>
 <ce:surname>MacCarthy</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>AM</ce:given-name>
 <ce:surname>Gotham</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Depression and disability in Parkinson's disease: a follow-up study of 132 cases</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Psychol Med</sb:maintitle>
 </sb:title>
 <sb:volume-nr>18</sb:volume-nr>
 </sb:series>
 <sb:date>1988</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>49</sb:first-page>
 <sb:last-page>55</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib23"> <ce:label>23</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>GL</ce:given-name>
 <ce:surname>Brown</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>WP</ce:given-name>
 <ce:surname>Wilson</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Parkinsonism and depression</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>South Med J</sb:maintitle>
 </sb:title>
 <sb:volume-nr>65</sb:volume-nr>
 </sb:series>
 <sb:date>1972</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>540</sb:first-page>
 <sb:last-page>545</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib24"> <ce:label>24</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>GG</ce:given-name>
 <ce:surname>Celesia</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>WM</ce:given-name>
 <ce:surname>Wanamaker</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Psychiatric disturbances in Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Dis Nerv Syst</sb:maintitle>
 </sb:title>
 <sb:volume-nr>9</sb:volume-nr>
 </sb:series>
 <sb:date>1972</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>577</sb:first-page>
 <sb:last-page>583</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib25"> <ce:label>25</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>RHS</ce:given-name>
 <ce:surname>Mindham</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>CD</ce:given-name>
 <ce:surname>Marsden</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JD</ce:given-name>
 <ce:surname>Parkes</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Psychiatric symptoms during L-dopa therapy for Parkinson's disease and their relationship to physical disability</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Psychol Med</sb:maintitle>
 </sb:title>
 <sb:volume-nr>6</sb:volume-nr>
 </sb:series>
 <sb:date>1976</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>23</sb:first-page>
 <sb:last-page>33</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib26"> <ce:label>26</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>TS</ce:given-name>
 <ce:surname>Ehman</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>RJ</ce:given-name>
 <ce:surname>Beninger</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>MJ</ce:given-name>
 <ce:surname>Gawel</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Depressive symptoms in Parkinson's disease: a comparison with disabled control subjects</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Geriatr Psychiatry Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>2</sb:volume-nr>
 </sb:series>
 <sb:date>1990</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>3</sb:first-page>
 <sb:last-page>9</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib27"> <ce:label>27</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>AM</ce:given-name>
 <ce:surname>Gotham</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>RG</ce:given-name>
 <ce:surname>Brown</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>CD</ce:given-name>
 <ce:surname>Marsden</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Depression and Parkinson's disease: a qualitative and quantitative analysis</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Neurol Neurosurg Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>49</sb:volume-nr>
 </sb:series>
 <sb:date>1988</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>381</sb:first-page>
 <sb:last-page>389</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib28"> <ce:label>28</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Mayeux</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>Y</ce:given-name>
 <ce:surname>Stern</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>J</ce:given-name>
 <ce:surname>Rosen</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Depression, intellectual impairment, and Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Neurology</sb:maintitle>
 </sb:title>
 <sb:volume-nr>31</sb:volume-nr>
 </sb:series>
 <sb:date>1981</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>645</sb:first-page>
 <sb:last-page>650</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib29"> <ce:label>29</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>H</ce:given-name>
 <ce:surname>Mjones</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Paralysis agitans: a clinical and genetic study</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Acta Psychiatr Neurol Scand</sb:maintitle>
 </sb:title>
 <sb:volume-nr>54</sb:volume-nr>
 </sb:series>
 <sb:date>1949</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1</sb:first-page>
 <sb:last-page>195</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib30"> <ce:label>30</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>RH</ce:given-name>
 <ce:surname>Mindham</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Psychiatric symptoms in parkinsonism</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Neurol Neurosurg Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>33</sb:volume-nr>
 </sb:series>
 <sb:date>1970</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>188</sb:first-page>
 <sb:last-page>191</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib31"> <ce:label>31</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Brown</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>M</ce:given-name>
 <ce:surname>Jahanshahi</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Depression in Parkinson's disease: a psychosocial viewpoint, in Behavioral Neurology. Edited by Weiner WJ, Lang AE</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Adv Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>65</sb:volume-nr>
 </sb:series>
 <sb:date>1995</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>61</sb:first-page>
 <sb:last-page>84</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib32"> <ce:label>32</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>M</ce:given-name>
 <ce:surname>Stein</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>IJ</ce:given-name>
 <ce:surname>Henser</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JL</ce:given-name>
 <ce:surname>Juncos</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Anxiety disorders in patients with Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Am J Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>147</sb:volume-nr>
 </sb:series>
 <sb:date>1990</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>217</sb:first-page>
 <sb:last-page>220</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib33"> <ce:label>33</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>J</ce:given-name>
 <ce:surname>Andersen</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>E</ce:given-name>
 <ce:surname>Aabro</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>N</ce:given-name>
 <ce:surname>Gulman</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Antidepressive treatment in Parkinson's disease: a controlled trial of the effect of nortriptyline in patients with Parkinson's disease treated with L-dopa</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Acta Neurol Scand</sb:maintitle>
 </sb:title>
 <sb:volume-nr>62</sb:volume-nr>
 </sb:series>
 <sb:date>1980</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>210</sb:first-page>
 <sb:last-page>219</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib34"> <ce:label>34</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>MA</ce:given-name>
 <ce:surname>Menza</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>DE</ce:given-name>
 <ce:surname>Robertson-Hoffman</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>AS</ce:given-name>
 <ce:surname>Bonapace</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Parkinson's disease and anxiety: comorbidity with depression</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Biol Psych</sb:maintitle>
 </sb:title>
 <sb:volume-nr>34</sb:volume-nr>
 </sb:series>
 <sb:date>1993</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>465</sb:first-page>
 <sb:last-page>470</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib35"> <ce:label>35</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Henderson</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Kurlan</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JM</ce:given-name>
 <ce:surname>Kersun</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Preliminary examination of the comorbidity of anxiety and depression in Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Neuropsychiatry Clin Neurosci</sb:maintitle>
 </sb:title>
 <sb:volume-nr>4</sb:volume-nr>
 </sb:series>
 <sb:date>1992</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>257</sb:first-page>
 <sb:last-page>264</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib36"> <ce:label>36</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>A</ce:given-name>
 <ce:surname>Vasquez</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>FJ</ce:given-name>
 <ce:surname>Jimenez-Jimenez</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>P</ce:given-name>
 <ce:surname>Garcia-Ruiz</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Panic attacks in Parkinson's disease: a long-term complication of levodopa therapy</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Acta Neurol Scand</sb:maintitle>
 </sb:title>
 <sb:volume-nr>87</sb:volume-nr>
 </sb:series>
 <sb:date>1993</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>14</sb:first-page>
 <sb:last-page>18</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib37"> <ce:label>37</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>SE</ce:given-name>
 <ce:surname>Starkstein</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>L</ce:given-name>
 <ce:surname>Sabe</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>G</ce:given-name>
 <ce:surname>Petracca</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Neuropsychological and psychiatric differences between Alzheimer's disease and Parkinson's disease with dementia</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Neurol Neurosurg Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>61</sb:volume-nr>
 </sb:series>
 <sb:date>1996</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>381</sb:first-page>
 <sb:last-page>387</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib38"> <ce:label>38</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>D</ce:given-name>
 <ce:surname>Aarsland</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>E</ce:given-name>
 <ce:surname>Tandberg</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JP</ce:given-name>
 <ce:surname>Larsen</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Frequency of dementia in Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>53</sb:volume-nr>
 </sb:series>
 <sb:date>1996</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>538</sb:first-page>
 <sb:last-page>542</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib39"> <ce:label>39</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>AI</ce:given-name>
 <ce:surname>Troster</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>LD</ce:given-name>
 <ce:surname>Stalp</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>AM</ce:given-name>
 <ce:surname>Paolo</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Neuropsychological impairment in Parkinson's disease with and without depression</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>52</sb:volume-nr>
 </sb:series>
 <sb:date>1995</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1164</sb:first-page>
 <sb:last-page>1169</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib40"> <ce:label>40</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>K</ce:given-name>
 <ce:surname>Marder</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>MX</ce:given-name>
 <ce:surname>Tang</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>L</ce:given-name>
 <ce:surname>Cote</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>The frequency and associated risk factors for dementia in patients with Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>52</sb:volume-nr>
 </sb:series>
 <sb:date>1995</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>695</sb:first-page>
 <sb:last-page>701</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib41"> <ce:label>41</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>ME</ce:given-name>
 <ce:surname>Duncombe</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JL</ce:given-name>
 <ce:surname>Bradshaw</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Iansek</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Parkinsonian patients without dementia or depression do not suffer from bradyphrenia as indexed by performance in mental rotation tasks with and without advance information</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Neuropsychologia</sb:maintitle>
 </sb:title>
 <sb:volume-nr>32</sb:volume-nr>
 </sb:series>
 <sb:date>1994</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1383</sb:first-page>
 <sb:last-page>1396</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib42"> <ce:label>42</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>S</ce:given-name>
 <ce:surname>Kalra</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>C</ce:given-name>
 <ce:surname>Bergeron</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>AE</ce:given-name>
 <ce:surname>Lang</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Lewy-body disease and dementia: a review</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Intern Med</sb:maintitle>
 </sb:title>
 <sb:volume-nr>156</sb:volume-nr>
 </sb:series>
 <sb:date>1996</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>487</sb:first-page>
 <sb:last-page>493</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib43"> <ce:label>43</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>ED</ce:given-name>
 <ce:surname>Louis</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JE</ce:given-name>
 <ce:surname>Goldman</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JM</ce:given-name>
 <ce:surname>Powers</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Parkinsonian features of eight pathologically diagnosed cases of diffuse Lewy-body disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Mov Disord</sb:maintitle>
 </sb:title>
 <sb:volume-nr>10</sb:volume-nr>
 </sb:series>
 <sb:date>1995</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>188</sb:first-page>
 <sb:last-page>194</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib44"> <ce:label>44</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>LA</ce:given-name>
 <ce:surname>Klatka</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>ED</ce:given-name>
 <ce:surname>Louis</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>RB</ce:given-name>
 <ce:surname>Schiffer</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Psychiatric features in diffuse Lewy-body disease: a clinicopathologic study using Alzheimer's disease and Parkinson's disease comparison groups</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Neurology</sb:maintitle>
 </sb:title>
 <sb:volume-nr>47</sb:volume-nr>
 </sb:series>
 <sb:date>1996</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1148</sb:first-page>
 <sb:last-page>1152</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib45"> <ce:label>45</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JJ</ce:given-name>
 <ce:surname>Schildkraut</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>The catecholamine hypothesis of affective disorders: a review of supporting evidence</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Am J Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>122</sb:volume-nr>
 </sb:series>
 <sb:date>1965</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>509</sb:first-page>
 <sb:last-page>522</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib46"> <ce:label>46</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JO</ce:given-name>
 <ce:surname>Cole</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>RT</ce:given-name>
 <ce:surname>Jones</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>GL</ce:given-name>
 <ce:surname>Klerman</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Drug therapy</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:edited-book> <sb:editors> <sb:editor> <ce:given-name>EA</ce:given-name>
 <ce:surname>Spiegel</ce:surname>
 </sb:editor>
 </sb:editors>
 <sb:title> <sb:maintitle>Progress in Neurology and Psychiatry</sb:maintitle>
 </sb:title>
 <sb:date>1961</sb:date>
 <sb:publisher> <sb:name>Grune & Stratton</sb:name>
 <sb:location>New York</sb:location>
 </sb:publisher>
 </sb:edited-book>
 <sb:pages> <sb:first-page>539</sb:first-page>
 <sb:last-page>574</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib47"> <ce:label>47</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JO</ce:given-name>
 <ce:surname>Cole</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>GL</ce:given-name>
 <ce:surname>Klerman</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>RT</ce:given-name>
 <ce:surname>Jones</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Drug therapy</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:edited-book> <sb:editors> <sb:editor> <ce:given-name>EA</ce:given-name>
 <ce:surname>Spiegel</ce:surname>
 </sb:editor>
 </sb:editors>
 <sb:title> <sb:maintitle>Progress in Neurology and Psychiatry</sb:maintitle>
 </sb:title>
 <sb:date>1961</sb:date>
 <sb:publisher> <sb:name>Grune & Stratton</sb:name>
 <sb:location>New York</sb:location>
 </sb:publisher>
 </sb:edited-book>
 <sb:pages> <sb:first-page>540</sb:first-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib48"> <ce:label>48</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>HM</ce:given-name>
 <ce:surname>Van Praag</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Kahn</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>GM</ce:given-name>
 <ce:surname>Asnis</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Therapeutic indications for serotonin-potentiating compounds: a hypothesis</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Biol Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>22</sb:volume-nr>
 </sb:series>
 <sb:date>1989</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>205</sb:first-page>
 <sb:last-page>212</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib49"> <ce:label>49</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>G</ce:given-name>
 <ce:surname>Serra</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>A</ce:given-name>
 <ce:surname>Argiolas</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>V</ce:given-name>
 <ce:surname>Klimek</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Chronic treatment with antidepressants prevents the inhibitory effect of small doses of apomorphine on dopamine synthesis and motor activity</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Life Sci</sb:maintitle>
 </sb:title>
 <sb:volume-nr>25</sb:volume-nr>
 </sb:series>
 <sb:date>1979</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>415</sb:first-page>
 <sb:last-page>424</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib50"> <ce:label>50</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>S</ce:given-name>
 <ce:surname>Fahn</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>LR</ce:given-name>
 <ce:surname>Libsch</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>RW</ce:given-name>
 <ce:surname>Cutler</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Monoamines in the human neostriatum: topographic distribution in normals and in Parkinson's disease and their role in akinesia, rigidity, chorea, and tremor</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Neurol Sci</sb:maintitle>
 </sb:title>
 <sb:volume-nr>14</sb:volume-nr>
 </sb:series>
 <sb:date>1971</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>427</sb:first-page>
 <sb:last-page>455</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib51"> <ce:label>51</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Sjostrom</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>BE</ce:given-name>
 <ce:surname>Ross</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>5-Hydroxyindoleacetic acid and homovanillic acid in cerebrospinal fluid in manic-depressive psychosis and the effect of probenecid treatment</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Eur J Clin Pharmacol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>6</sb:volume-nr>
 </sb:series>
 <sb:date>1973</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>75</sb:first-page>
 <sb:last-page>80</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib52"> <ce:label>52</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>HM</ce:given-name>
 <ce:surname>van Praag</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>J</ce:given-name>
 <ce:surname>Korf</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>T</ce:given-name>
 <ce:surname>Schut</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Cerebral monoamines and depression: an investigation with the probenecid technique</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Gen Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>28</sb:volume-nr>
 </sb:series>
 <sb:date>1973</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>827</sb:first-page>
 <sb:last-page>831</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib53"> <ce:label>53</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>GW</ce:given-name>
 <ce:surname>Ashcroft</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>TBB</ce:given-name>
 <ce:surname>Crawford</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>D</ce:given-name>
 <ce:surname>Eccleston</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>5-Hydroxy-indole compounds in the cerebrospinal fluid of patients with psychiatric or neurological diseases</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Lancet</sb:maintitle>
 </sb:title>
 <sb:volume-nr>2</sb:volume-nr>
 </sb:series>
 <sb:date>1966</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1049</sb:first-page>
 <sb:last-page>1052</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib54"> <ce:label>54</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>BE</ce:given-name>
 <ce:surname>Roos</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Sjostrom</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>5-Hydroxyindoleacetic acid (and homovanillic acid) levels in the cerebrospinal fluid after probenecid application in patients with manic-depressive psychosis</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Pharmacol Clin</sb:maintitle>
 </sb:title>
 <sb:volume-nr>1</sb:volume-nr>
 </sb:series>
 <sb:date>1969</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>153</sb:first-page>
 <sb:last-page>155</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib55"> <ce:label>55</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>RA</ce:given-name>
 <ce:surname>Wise</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Catecholamine theories of reward: a critical review</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Brain Res</sb:maintitle>
 </sb:title>
 <sb:volume-nr>152</sb:volume-nr>
 </sb:series>
 <sb:date>1978</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>215</sb:first-page>
 <sb:last-page>247</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib56"> <ce:label>56</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JR</ce:given-name>
 <ce:surname>Stevens</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>A</ce:given-name>
 <ce:surname>Livermore</ce:surname>
 <ce:suffix>Jr</ce:suffix>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Kindling of the mesolimbic dopamine system: animal model of psychosis</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Neurology</sb:maintitle>
 </sb:title>
 <sb:volume-nr>28</sb:volume-nr>
 </sb:series>
 <sb:date>1978</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>36</sb:first-page>
 <sb:last-page>46</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib57"> <ce:label>57</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>RM</ce:given-name>
 <ce:surname>Torack</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JC</ce:given-name>
 <ce:surname>Morris</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>The association of ventral tegmental area histopathology with adult dementia</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>45</sb:volume-nr>
 </sb:series>
 <sb:date>1988</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>497</sb:first-page>
 <sb:last-page>501</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib58"> <ce:label>58</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>J</ce:given-name>
 <ce:surname>Glowinski</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JP</ce:given-name>
 <ce:surname>Tassin</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>AM</ce:given-name>
 <ce:surname>Thierry</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>The mesocortico-prefrontal dopaminergic neurons</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Trends Neurosci</sb:maintitle>
 </sb:title>
 <sb:volume-nr>7</sb:volume-nr>
 </sb:series>
 <sb:date>1984</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>415</sb:first-page>
 <sb:last-page>418</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib59"> <ce:label>59</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>H</ce:given-name>
 <ce:surname>Simon</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>M</ce:given-name>
 <ce:surname>LeMoal</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>A</ce:given-name>
 <ce:surname>Calas</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Efferents and afferents of the ventral tegmental A-10 region studies after local injection of [3 H]-leucine and horseradish peroxidase</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Brain Res</sb:maintitle>
 </sb:title>
 <sb:volume-nr>178</sb:volume-nr>
 </sb:series>
 <sb:date>1979</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>17</sb:first-page>
 <sb:last-page>40</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib60"> <ce:label>60</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>H</ce:given-name>
 <ce:surname>Mayberg</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>SE</ce:given-name>
 <ce:surname>Starkstein</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>B</ce:given-name>
 <ce:surname>Sadzot</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Selective hypometabolism in the inferior frontal lobe in depressed patients with Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Ann Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>28</sb:volume-nr>
 </sb:series>
 <sb:date>1990</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>57</sb:first-page>
 <sb:last-page>64</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib61"> <ce:label>61</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Mayeux</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Depression in the patient with Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Clin Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>51</sb:volume-nr>
 </sb:series>
 <sb:date>1990</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>20</sb:first-page>
 <sb:last-page>23</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib62"> <ce:label>62</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>RR</ce:given-name>
 <ce:surname>Strang</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Imipramine in treatment of parkinsonism: a double-blind placebo study</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Br Med J</sb:maintitle>
 </sb:title>
 <sb:volume-nr>2</sb:volume-nr>
 </sb:series>
 <sb:date>1965</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>33</sb:first-page>
 <sb:last-page>34</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib63"> <ce:label>63</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>L</ce:given-name>
 <ce:surname>Laitinen</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Desipramine in treatment of Parkinson's disease: a placebo-controlled study</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Acta Neurol Scand</sb:maintitle>
 </sb:title>
 <sb:volume-nr>45</sb:volume-nr>
 </sb:series>
 <sb:date>1969</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>109</sb:first-page>
 <sb:last-page>113</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib64"> <ce:label>64</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JC</ce:given-name>
 <ce:surname>Denmark</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JDP</ce:given-name>
 <ce:surname>David</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>SG</ce:given-name>
 <ce:surname>McComb</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Imipramine hydrochloride (Tofranil) in parkinsonism: a preliminary report</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Br J Clin Prac</sb:maintitle>
 </sb:title>
 <sb:volume-nr>15</sb:volume-nr>
 </sb:series>
 <sb:date>1961</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>523</sb:first-page>
 <sb:last-page>524</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib65"> <ce:label>65</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>A</ce:given-name>
 <ce:surname>Randrup</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>I</ce:given-name>
 <ce:surname>Munkvad</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>J</ce:given-name>
 <ce:surname>Fog</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Mania, depression, and brain dopamine</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:edited-book> <sb:editors> <sb:editor> <ce:given-name>WB</ce:given-name>
 <ce:surname>Essman</ce:surname>
 </sb:editor>
 <sb:editor> <ce:given-name>L</ce:given-name>
 <ce:surname>Vlazelli</ce:surname>
 </sb:editor>
 </sb:editors>
 <sb:title> <sb:maintitle>Current Developments in Psychopharmacology</sb:maintitle>
 </sb:title>
 <sb:date>1975</sb:date>
 <sb:publisher> <sb:name>Robert B. Luce</sb:name>
 <sb:location>Fairfield, CT</sb:location>
 </sb:publisher>
 </sb:edited-book>
 <sb:pages> <sb:first-page>206</sb:first-page>
 <sb:last-page>248</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib66"> <ce:label>66</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>PK</ce:given-name>
 <ce:surname>Ghosh</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>PD</ce:given-name>
 <ce:surname>Hrdina</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Effects of tricyclic antidepressants on the content and metabolism of dopamine in the rat striatum</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Can J Physiol Pharmacol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>55</sb:volume-nr>
 </sb:series>
 <sb:date>1976</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>383</sb:first-page>
 <sb:last-page>388</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib67"> <ce:label>67</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>AE</ce:given-name>
 <ce:surname>Halaris</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>KT</ce:given-name>
 <ce:surname>Belendiuk</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>DX</ce:given-name>
 <ce:surname>Freedman</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Antidepressant drugs affect dopamine uptake</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Biochem Pharmacol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>24</sb:volume-nr>
 </sb:series>
 <sb:date>1975</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1896</sb:first-page>
 <sb:last-page>1897</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib68"> <ce:label>68</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>HS</ce:given-name>
 <ce:surname>Alpers</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>HE</ce:given-name>
 <ce:surname>Himwich</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Effects of repeated daily injections of imipramine on brain levels of serotonin, 5-hydroxyindoleacetic acid, norepinephrine and dopamine (abstract)</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Federation Proceedings</sb:maintitle>
 </sb:title>
 <sb:volume-nr>30</sb:volume-nr>
 </sb:series>
 <sb:date>1971</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>672</sb:first-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib69"> <ce:label>69</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>RA</ce:given-name>
 <ce:surname>Hauser</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>TA</ce:given-name>
 <ce:surname>Zesiewicz</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Sertraline for the treatment of depression in Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Mov Disord</sb:maintitle>
 </sb:title>
 <sb:volume-nr>12</sb:volume-nr>
 </sb:series>
 <sb:date>1997</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>756</sb:first-page>
 <sb:last-page>757</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib70"> <ce:label>70</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>RJ</ce:given-name>
 <ce:surname>Meara</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>BK</ce:given-name>
 <ce:surname>Bhowmick</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JP</ce:given-name>
 <ce:surname>Hobson</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>An open uncontrolled study of the use of sertraline in the treatment of depression in Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Journal of Serotonin Research</sb:maintitle>
 </sb:title>
 <sb:volume-nr>4</sb:volume-nr>
 </sb:series>
 <sb:date>1996</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>243</sb:first-page>
 <sb:last-page>249</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib71"> <ce:label>71</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>W</ce:given-name>
 <ce:surname>Wittgens</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>O</ce:given-name>
 <ce:surname>Donath</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>U</ce:given-name>
 <ce:surname>Trenckmann</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Treatment of depressive syndromes in Parkinson's disease with paroxetine (abstract)</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Mov Disord</sb:maintitle>
 </sb:title>
 <sb:volume-nr>12</sb:volume-nr>
 </sb:series>
 <sb:date>1997</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>128</sb:first-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib72"> <ce:label>72</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>CG</ce:given-name>
 <ce:surname>Goetz</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>CM</ce:given-name>
 <ce:surname>Tanner</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>HL</ce:given-name>
 <ce:surname>Klawans</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Bupropion in Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Neurology</sb:maintitle>
 </sb:title>
 <sb:volume-nr>34</sb:volume-nr>
 </sb:series>
 <sb:date>1984</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1092</sb:first-page>
 <sb:last-page>1094</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib73"> <ce:label>73</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>E</ce:given-name>
 <ce:surname>Jansen Steur</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Increase of Parkinson disability after fluoxetine medication</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Neurology</sb:maintitle>
 </sb:title>
 <sb:volume-nr>43</sb:volume-nr>
 </sb:series>
 <sb:date>1993</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>211</sb:first-page>
 <sb:last-page>213</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib74"> <ce:label>74</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>G</ce:given-name>
 <ce:surname>Chouinard</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>S</ce:given-name>
 <ce:surname>Sultan</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>A case of Parkinson's disease exacerbated by fluoxetine (letter)</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Hum Psychopharmacol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>7</sb:volume-nr>
 </sb:series>
 <sb:date>1992</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>63</sb:first-page>
 <sb:last-page>66</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib75"> <ce:label>75</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>FJ</ce:given-name>
 <ce:surname>Jimenez-Jimenez</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>J</ce:given-name>
 <ce:surname>Tejeiro</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>G</ce:given-name>
 <ce:surname>Martinez-Junquera</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Parkinsonism exacerbated by paroxetine (letter)</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Neurology</sb:maintitle>
 </sb:title>
 <sb:volume-nr>44</sb:volume-nr>
 </sb:series>
 <sb:date>1994</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>2406</sb:first-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib76"> <ce:label>76</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>RH</ce:given-name>
 <ce:surname>Bouchard</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>E</ce:given-name>
 <ce:surname>Pourcher</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>P</ce:given-name>
 <ce:surname>Vincent</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Fluoxetine and extrapyramidal side effects</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Am J Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>146</sb:volume-nr>
 </sb:series>
 <sb:date>1989</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1352</sb:first-page>
 <sb:last-page>1353</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib77"> <ce:label>77</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JL</ce:given-name>
 <ce:surname>Tate</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Extrapyramidal symptoms in a patient taking haldoperidol and fluoxetine</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Am J Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>146</sb:volume-nr>
 </sb:series>
 <sb:date>1989</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>399</sb:first-page>
 <sb:last-page>400</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib78"> <ce:label>78</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>TM</ce:given-name>
 <ce:surname>Brod</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Fluoxetine and extrapyramidal side effects (letter)</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Am J Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>146</sb:volume-nr>
 </sb:series>
 <sb:date>1989</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1353</sb:first-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib79"> <ce:label>79</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>LS</ce:given-name>
 <ce:surname>Austin</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>GW</ce:given-name>
 <ce:surname>Arana</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JA</ce:given-name>
 <ce:surname>Melvin</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Toxicity resulting from lithium augmentation of antidepressant treatment in elderly patients</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Clin Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>51</sb:volume-nr>
 </sb:series>
 <sb:date>1990</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>344</sb:first-page>
 <sb:last-page>345</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib80"> <ce:label>80</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>RJ</ce:given-name>
 <ce:surname>Leo</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>DG</ce:given-name>
 <ce:surname>Lichter</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>LA</ce:given-name>
 <ce:surname>Hershey</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Parkinsonism associated with fluoxetine and cimetidine: a case report</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Geriatr Psychiatry Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>8</sb:volume-nr>
 </sb:series>
 <sb:date>1995</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>231</sb:first-page>
 <sb:last-page>233</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib81"> <ce:label>81</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>V</ce:given-name>
 <ce:surname>Wils</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Extrapyramidal symptoms in a patient treated with fluvoxamine (letter)</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Neurol Neurosurg Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>55</sb:volume-nr>
 </sb:series>
 <sb:date>1992</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>330</sb:first-page>
 <sb:last-page>331</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib82"> <ce:label>82</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JL</ce:given-name>
 <ce:surname>Montastruc</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>N</ce:given-name>
 <ce:surname>Fabre</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>O</ce:given-name>
 <ce:surname>Blin</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Does fluoxetine aggravate Parkinson's disease? a pilot prospective study</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Mov Disord</sb:maintitle>
 </sb:title>
 <sb:volume-nr>10</sb:volume-nr>
 </sb:series>
 <sb:date>1995</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>355</sb:first-page>
 <sb:last-page>356</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib83"> <ce:label>83</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>CF</ce:given-name>
 <ce:surname>Caley</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JH</ce:given-name>
 <ce:surname>Friedman</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Does fluoxetine exacerbate Parkinson's disease?</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Clin Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>53</sb:volume-nr>
 </sb:series>
 <sb:date>1992</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>278</sb:first-page>
 <sb:last-page>282</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib84"> <ce:label>84</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JP</ce:given-name>
 <ce:surname>Feigher</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>WF</ce:given-name>
 <ce:surname>Boyer</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>DL</ce:given-name>
 <ce:surname>Tyler</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Adverse consequences of fluoxetine–MAOI combination therapy</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Clin Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>51</sb:volume-nr>
 </sb:series>
 <sb:date>1990</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>222</sb:first-page>
 <sb:last-page>225</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib85"> <ce:label>85</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>Q</ce:given-name>
 <ce:surname>Suchowersky</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>J</ce:given-name>
 <ce:surname>DeVries</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Possible interactions between deprenyl and Prozac</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Can J Neurol Sci</sb:maintitle>
 </sb:title>
 <sb:volume-nr>17</sb:volume-nr>
 </sb:series>
 <sb:date>1990</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>352</sb:first-page>
 <sb:last-page>353</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib86"> <ce:label>86</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JL</ce:given-name>
 <ce:surname>Montastruc</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>B</ce:given-name>
 <ce:surname>Chamontin</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JM</ce:given-name>
 <ce:surname>Senard</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Pseudophaeochromocytoma in parkinsonian patient treated with fluoxetine plus selegiline (letter)</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Lancet</sb:maintitle>
 </sb:title>
 <sb:volume-nr>341</sb:volume-nr>
 </sb:series>
 <sb:date>1993</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>555</sb:first-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib87"> <ce:label>87</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>CH</ce:given-name>
 <ce:surname>Waters</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Fluoxetine and selegiline</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Can J Neurol Sci</sb:maintitle>
 </sb:title>
 <sb:volume-nr>21</sb:volume-nr>
 </sb:series>
 <sb:date>1994</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>259</sb:first-page>
 <sb:last-page>261</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib88"> <ce:label>88</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>SC</ce:given-name>
 <ce:surname>Toyama</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>RP</ce:given-name>
 <ce:surname>Iacono</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Is it safe to combine a selective serotonin reuptake inhibitor with selegiline?</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Ann Pharmacother</sb:maintitle>
 </sb:title>
 <sb:volume-nr>28</sb:volume-nr>
 </sb:series>
 <sb:date>1994</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>405</sb:first-page>
 <sb:last-page>406</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib89"> <ce:label>89</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>I</ce:given-name>
 <ce:surname>Richard</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Kurlan</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>C</ce:given-name>
 <ce:surname>Tanner</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Serotonin syndrome and the combined use of deprenyl and an antidepressant in Parkinson's disease: Parkinson Study Group</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Neurology</sb:maintitle>
 </sb:title>
 <sb:volume-nr>48</sb:volume-nr>
 </sb:series>
 <sb:date>1997</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1070</sb:first-page>
 <sb:last-page>1077</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib90"> <ce:label>90</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>J</ce:given-name>
 <ce:surname>Knoll</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>Z</ce:given-name>
 <ce:surname>Ecseri</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>K</ce:given-name>
 <ce:surname>Kelemen</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Phenylisopropylmethylpropinylamine (E-250), a new spectrum psychic energizer</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Archives Internationales de Pharmacodynamie et de Therapie</sb:maintitle>
 </sb:title>
 <sb:volume-nr>155</sb:volume-nr>
 </sb:series>
 <sb:date>1965</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>154</sb:first-page>
 <sb:last-page>164</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib91"> <ce:label>91</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:surname>Parkinson Study Group</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Effects of tocopherol and deprenyl on the progression of disability in early Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>N Engl J Med</sb:maintitle>
 </sb:title>
 <sb:volume-nr>328</sb:volume-nr>
 </sb:series>
 <sb:date>1993</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>176</sb:first-page>
 <sb:last-page>183</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib92"> <ce:label>92</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>CW</ce:given-name>
 <ce:surname>Olanow</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>RA</ce:given-name>
 <ce:surname>Hauser</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>L</ce:given-name>
 <ce:surname>Gauger</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>The effect of deprenyl and levodopa on the progression of Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Ann Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>38</sb:volume-nr>
 </sb:series>
 <sb:date>1995</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>771</sb:first-page>
 <sb:last-page>777</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib93"> <ce:label>93</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>PJ</ce:given-name>
 <ce:surname>McGrath</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>JW</ce:given-name>
 <ce:surname>Stewart</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>FM</ce:given-name>
 <ce:surname>Quitkin</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>A possible L-deprenyl-induced hypertensive reaction</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>J Clin Psychopharmacol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>9</sb:volume-nr>
 </sb:series>
 <sb:date>1989</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>310</sb:first-page>
 <sb:last-page>311</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib94"> <ce:label>94</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>JJ</ce:given-name>
 <ce:surname>Mann</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>SF</ce:given-name>
 <ce:surname>Aarons</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>PJ</ce:given-name>
 <ce:surname>Wilner</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>A controlled study of the antidepressant efficacy and side effects of (-)-deprenyl: a selective monoamine oxidase inhibitor</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Gen Psychiatry</sb:maintitle>
 </sb:title>
 <sb:volume-nr>46</sb:volume-nr>
 </sb:series>
 <sb:date>1989</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>45</sb:first-page>
 <sb:last-page>50</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib95"> <ce:label>95</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>SJ</ce:given-name>
 <ce:surname>Boyson</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Psychiatric effects of selegiline (letter)</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Neurol</sb:maintitle>
 </sb:title>
 <sb:volume-nr>48</sb:volume-nr>
 </sb:series>
 <sb:date>1991</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>902</sb:first-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib96"> <ce:label>96</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:surname>Lees AJ (on behalf of the Parkinson's Disease Research Group of the United Kingdom)</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Comparison of therapeutic effects and mortality data of levodopa and levodopa combined with selegiline in patients with early, mild Parkinson's disease</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Br Med J</sb:maintitle>
 </sb:title>
 </sb:series>
 <sb:date>1995</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>1601</sb:first-page>
 <sb:last-page>1607</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib97"> <ce:label>97</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>CW</ce:given-name>
 <ce:surname>Olanow</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Selegiline: current perspectives on issues related to neuroprotection and mortality</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Neurology</sb:maintitle>
 </sb:title>
 <sb:volume-nr>47</sb:volume-nr>
 </sb:series>
 <sb:issue-nr>suppl 3</sb:issue-nr>
 <sb:date>1996</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>S210</sb:first-page>
 <sb:last-page>S216</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib98"> <ce:label>98</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>T</ce:given-name>
 <ce:surname>Sunderland</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>R</ce:given-name>
 <ce:surname>Cohen</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>S</ce:given-name>
 <ce:surname>Molchan</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>High-dose selegiline in treatment-resistant older depressive patients</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Arch Gen Psych</sb:maintitle>
 </sb:title>
 <sb:volume-nr>51</sb:volume-nr>
 </sb:series>
 <sb:date>1994</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>607</sb:first-page>
 <sb:last-page>615</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib99"> <ce:label>99</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>GJ</ce:given-name>
 <ce:surname>Marek</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>LS</ce:given-name>
 <ce:surname>Seiden</ce:surname>
 </sb:author>
 </sb:authors>
 <sb:title> <sb:maintitle>Selective inhibition of MAO-A, not MAO-B, results in antidepressant-like effects on DRL 72-S behavior</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Psychopharmacol Bull</sb:maintitle>
 </sb:title>
 <sb:volume-nr>96</sb:volume-nr>
 </sb:series>
 <sb:date>1988</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>153</sb:first-page>
 <sb:last-page>160</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 <ce:bib-reference id="bib100"> <ce:label>100</ce:label>
 <sb:reference> <sb:contribution> <sb:authors> <sb:author> <ce:given-name>N</ce:given-name>
 <ce:surname>Mendis</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>CMB</ce:given-name>
 <ce:surname>Pare</ce:surname>
 </sb:author>
 <sb:author> <ce:given-name>M</ce:given-name>
 <ce:surname>Sandler</ce:surname>
 </sb:author>
 <sb:et-al></sb:et-al>
 </sb:authors>
 <sb:title> <sb:maintitle>Is the failure of L-deprenyl, a selective MAO-B inhibitor, to alleviate depression related to freedom from cheese effect?</sb:maintitle>
 </sb:title>
 </sb:contribution>
 <sb:host> <sb:issue> <sb:series> <sb:title> <sb:maintitle>Psychopharmacol Bull</sb:maintitle>
 </sb:title>
 <sb:volume-nr>73</sb:volume-nr>
 </sb:series>
 <sb:date>1981</sb:date>
 </sb:issue>
 <sb:pages> <sb:first-page>87</sb:first-page>
 <sb:last-page>90</sb:last-page>
 </sb:pages>
 </sb:host>
 </sb:reference>
 </ce:bib-reference>
 </ce:bibliography-sec>
 </ce:bibliography>
 </tail>
</article>
</istex:document>
</istex:metadataXml>
<mods version="3.6"><titleInfo><title>Current Issues in Depression in Parkinson's Disease</title>
</titleInfo>
<titleInfo type="alternative" contentType="CDATA"><title>Current Issues in Depression in Parkinson's Disease</title>
</titleInfo>
<name type="personal"><namePart type="given">Theresa A.</namePart>
<namePart type="family">Zesiewicz</namePart>
<namePart type="termsOfAddress">M.D.</namePart>
<affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Michael</namePart>
<namePart type="family">Gold</namePart>
<namePart type="termsOfAddress">M.D.</namePart>
<affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Ganesh</namePart>
<namePart type="family">Chari</namePart>
<namePart type="termsOfAddress">M.D.</namePart>
<affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Robert A.</namePart>
<namePart type="family">Hauser</namePart>
<namePart type="termsOfAddress">M.D.</namePart>
<affiliation>Parkinson's Disease and Movement Disorders Center, Tampa, Florida</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<typeOfResource>text</typeOfResource>
<genre type="research-article" displayLabel="Full-length article"></genre>
<originInfo><publisher>ELSEVIER</publisher>
<dateIssued encoding="w3cdtf">1998</dateIssued>
<dateValid encoding="w3cdtf">1998-06-22</dateValid>
<dateModified encoding="w3cdtf">1998-06-02</dateModified>
<copyrightDate encoding="w3cdtf">1999</copyrightDate>
</originInfo>
<language><languageTerm type="code" authority="iso639-2b">eng</languageTerm>
<languageTerm type="code" authority="rfc3066">en</languageTerm>
</language>
<physicalDescription><internetMediaType>text/html</internetMediaType>
</physicalDescription>
<abstract>Depression affects 4050 of Parkinson's disease (PD) patients. The authors, by use of a Mednet and manual search of pertinent literature, summarize current issues in the treatment of depression in PD. Open-label studies suggest that antidepressants may be effective for treating depression in PD. Although case reports indicate that selective serotonin reuptake inhibitors (SSRIs) can potentially worsen the motor symptoms of PD, this effect has not been confirmed in the small number of open-label studies that have been performed to date. The occurrence of the serotonin syndrome resulting from a combination of selegiline and an SSRI appears to be rare. Double-blind prospective studies are needed to evaluate the safety and efficacy of antidepressants in PD and their effect on motor function.</abstract>
<note type="content">Section title: Special Articles</note>
<relatedItem type="host"><titleInfo><title>The American Journal of Geriatric Psychiatry</title>
</titleInfo>
<titleInfo type="abbreviated"><title>AMGP</title>
</titleInfo>
<genre type="Journal">journal</genre>
<originInfo><dateIssued encoding="w3cdtf">199921</dateIssued>
</originInfo>
<identifier type="ISSN">1064-7481</identifier>
<identifier type="PII">S1064-7481(12)X6099-8</identifier>
<part><date>199921</date>
<detail type="volume"><number>7</number>
<caption>vol.</caption>
</detail>
<detail type="issue"><number>2</number>
<caption>no.</caption>
</detail>
<extent unit="issue pages"><start>93</start>
<end>176</end>
</extent>
<extent unit="pages"><start>110</start>
<end>118</end>
</extent>
</part>
</relatedItem>
<identifier type="istex">437EFFEF2C350B16AA41EF7FA65ED538ECBE895F</identifier>
<identifier type="DOI">10.1097/00019442-199905000-00003</identifier>
<identifier type="PII">S1064-7481(12)61204-4</identifier>
<accessCondition type="use and reproduction" contentType="">© 1999American Association for Geriatric Psychiatry</accessCondition>
<recordInfo><recordContentSource>ELSEVIER</recordContentSource>
<recordOrigin>American Association for Geriatric Psychiatry, ©1999</recordOrigin>
</recordInfo>
</mods>
</metadata>
<enrichments><istex:catWosTEI uri="https://api.istex.fr/document/437EFFEF2C350B16AA41EF7FA65ED538ECBE895F/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">GERONTOLOGY</classCode>
<classCode scheme="WOS">GERIATRICS & GERONTOLOGY</classCode>
<classCode scheme="WOS">PSYCHIATRY</classCode>
</textClass>
</profileDesc>
</teiHeader>
</istex:catWosTEI>
</enrichments>
<serie></serie>
</istex>
</record>

Pour manipuler ce document sous Unix (Dilib)

EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/ParkinsonV1/Data/Main/Corpus

HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000957 | SxmlIndent | more

HfdSelect -h $EXPLOR_AREA/Data/Main/Corpus/biblio.hfd -nk 000957 | SxmlIndent | more

Pour mettre un lien sur cette page dans le réseau Wicri

{{Explor lien
   |wiki=    Wicri/Sante
   |area=    ParkinsonV1
   |flux=    Main
   |étape=   Corpus
   |type=    RBID
   |clé=     ISTEX:437EFFEF2C350B16AA41EF7FA65ED538ECBE895F
   |texte=   Current Issues in Depression in Parkinson's Disease
}}

This area was generated with Dilib version V0.6.23.
Data generation: Sun Jul 3 18:06:51 2016. Site generation: Wed Mar 6 18:46:03 2024

	Serveur d'exploration sur la maladie de Parkinson
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.

Serveur d'exploration sur la maladie de Parkinson

Current Issues in Depression in Parkinson's Disease

Current Issues in Depression in Parkinson's Disease

Source :

Abstract

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri