Table 1. Management of Depression, Psychosis, and Dementia in Parkinson Disease
Depression
Screening: > Beck Depression Inventory (self- completion questionnaire, 21 items, range 0–52);
> Hamilton Depression Rating Scale (professionally administered, 17 items, range 0–63);
Treatment:
> Consider amitriptyline; > Anticholinergic side effects, especially problematic with TCAs (potential worsening of cognition, orthostatic hypotension increasing risk of falls).
> Montgomery Asberg Depression Rating Scale (professionally administered, 10 items, range 0–60).
Psychosis
Treatment: > Consider clozapine (associated with possibly fatal agranulocytosis, monitor absolute neutrophil count); > Consider quesiapine.
Dementia
Screening: > Cambridge Cognitive Examination (95% sensitivity, 94% specificity, covers additional domains of orientation, concentration, expression, memory, abstract thinking, drawing, understanding, writing);
quicker to administer).
Treatment: > Consider rivastigmine (modest improvement of cognitive function, also in dementia with Lewy bodies; tremor may be exacerbated);
> Consider donepezil (modest improvement of cognitive function).
> Mini-Mental State Examination (98% sensitivity, 77% specificity,
