Treatment Options for Depression in Parkinson's disease: a Mini-Review : ECT Discussed

 Out on PubMed,  from authors in Italy, is this article:

Treatment options for depression in Parkinson's disease: a mini-review.

Raggi A, Serretti A, Ferri R.Int Clin Psychopharmacol. 2025 Mar 13. doi: 10.1097/YIC.0000000000000588. Online ahead of print.PMID: 40071596

The abstract is copied below:

Depression is a common comorbidity in Parkinson's disease (PD), significantly reducing patients' quality of life. This mini-review examines pharmacological and nonpharmacological therapies for managing depression in PD, analyzing their benefits, and limitations. Pharmacological options include tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), levodopa, dopaminergic agonists, and monoamine oxidase B inhibitors. Nonpharmacological strategies involve brief psychodynamic therapy, cognitive-behavioral therapy (CBT), physical exercise, phytomedicine, massage therapy, music therapy, phototherapy, yoga, repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, electroconvulsive therapy (ECT), and deep brain stimulation. SSRIs, SNRIs, and some dopamine agonists have shown effectiveness and good tolerability, especially when combined with CBT or rTMS. For severe or refractory cases, ECT remains a viable option. Although many of these therapies show promise, the limited number and scale of studies for each treatment restrict the strength of current evidence. Further large-scale, multicenter randomized-controlled trials are essential to validate these preliminary findings and establish evidence-based guidelines. In addition, the potential benefits of social support and brief psychodynamic therapy in the context of PD-related depression require further exploration to provide holistic care strategies for this population.

The article is here.

And from the text:

It is always good to see ECT for PD described. While this review purports to cover benefits and limitations, for ECT it seems to be heavy on the limitations. The call for RCTs of ECT in PD is semi-ridiculous and a poor excuse to withhold the treatment in appropriate patients. On balance, however, I will still give these Italian authors a "buon lavoro" for including ECT.