Depression, anxiety, and fatigue occur more frequently in persons with a new diagnosis of Parkinson disease who have not been treated for the disease compared with the general population, according to a study in Neurology.

Daniel Weintraub, MD, and fellow investigators also found that patients who began dopamine replacement therapy, the most common therapy for Parkinson disease, more often experienced impulse-control disorders and excessive daytime sleepiness.

At the beginning of the 2-year study, Weintraub’s group assessed 196 healthy control subjects and 423 persons with a new diagnosis of Parkinson disease for global cognition and symptoms of depression, anxiety, psychosis, impulse-control disorders, sleep and wakefulness, apathy, and fatigue. None of the patients had undergone treatment for Parkinson disease at the time of study enrollment.

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Persons with Parkinson disease experienced depression, fatigue, apathy, and anxiety more than did healthy people at baseline, 12 months, and 24 months. Approximately two-thirds of patients with Parkinson disease and depression were not taking an antidepressant at any visit. Apathy and psychosis increased over time in the Parkinson group.

Patients on dopamine replacement therapy for at least 1 year (44% of the study group at 24 months) reported more excessive daytime sleepiness and incident impulse-control disorders. Dopamine therapy did help 33% of persons with Parkinson disease improve their fatigue test score over 24 months, compared with only 11% of Parkinson patients not on dopamine therapy.