A 56 Year Old Man with Parkinson’s Disease and Depression: A Case Report on Treatment Management

Abstract

Background: Depression is the strongest predictor of quality of life for Parkinson’s disease (PD).
Presentation of Case: A 56 years old man came with the main complaint of difficulty sleeping due to
thinking about tremors in his left hand since 6 months. Complaints are accompanied by feelings of sadness,
lack of enthusiasm, and decreased appetite accompanied by weight loss. The patient had been diagnosed
with PD 8 years previously and was on medication. One month before the visit, the patient underwent a
thalamotomy operation. After surgery, the patient received therapy in the form of a combination tablet
of levodopa/carbidopa/entacapaone (100/25/200 mg) 4×1 tablet and 1×2 mg of ropirinole. On the Beck
Depression Inventory (BDI) examination, a score of 23 was obtained and on the Montgomery Asberg
Depression Rating Scale (MADRS) examination a score of 31 was obtained, both of which correspond to
major depression. The patient was diagnosed with a major depressive episode without psychotic symptoms
and was given escitalopram therapy 1×10 mg and lorazepam 1×2 mg. Patients also received biofeedback
therapy with family psychoeducation and supportive psychotherapy. At the time of control, the patient
admitted to feeling calmer and able to sleep after receiving therapy. Conclusion: Escitalopram has good
efficacy for the management of depression in PD patients.