It is increasingly recognised that the non-motor effects of PD including depression and cognitive dysfunction can have a greater impact on patients' quality of life than the movement symptoms. The difficulty is that we are only at the stage of being able to recognise these symptoms and are just starting to integrate treatment options in to how we manage people. The difficulty is that the common PD drugs have only been tested on their efficacy for motor symptoms; there haven't been well-controlled trials of different antidepressants in PD although my group at King's College London is working on a large project to help understand the progress of PD-depression better.The other difficulty is convincing the professionals (and their funders and bosses) that PD has changed from a straightforward "more dopa or less dopa" situation to a much more complicated picture with management of multiple over-lapping symptoms; insomnia, diarhoea, constipation, anxiety, depression, hallucinations, fatigue, apathy, cognitive problems, memory difficulties... We'll do what we can from our side, maybe this calls for a research study???Paul
Mark