Parkinson's Research Studies on Anxiety and Depression

This research focuses on the common occurrence of anxiety and depressive symptoms in Parkinson's disease, which are often underdiagnosed. The impact on quality of life is significant, highlighting the need for effective treatment strategies. The ADePT-PD trial aims to assess the effectiveness of specific medications in managing depression and anxiety while potentially delaying motor progression in Parkinson's patients. Participation information and contact details for the trial are provided.

• Parkinsons
• Research
• Anxiety
• Depression
• ADePT-PD Trial

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1. Parkinsons Research Studies with focus on Anxiety and Depression Professor Anette Schrag Department of Clinical Neuroscience University College London

2. Anxiety and Depression in Parkinsons Common: 40-60% have Anxiety and >50% depressive symptoms Recognition: Very much underdiagnosed/misattributed Significant Impact: Major contributors to Quality of Life Treatment: Unclear Education and Support Psychological therapies Medications But which ones? Different approaches for different people/manifestations? How can we personalise and tailor treatment? Does treatment improve long term outcome of Parkinson s?

3. ADepT-PD: Trial for - Depressive symptoms Delay of Motor Progression - AND-PD: Understanding Anxiety in PD PD-Care (Live Well with Parkinson s): - Questionnaires Behavioural and cognitive tasks optional MRI - Qualitative interviews - Self-management tool with support - Personalised Information Online (or paper) - All can be done either Remotely (video) OR In person - -

4. ADepT-PD trial: Aims: Key inclusion criteria: Key exclusion criteria: Methods: Effectiveness of escitalopram and nortriptyline for depression and anxiety in PD Delaying motor progression with nortriptyline Any stage of PD Some depressive symptoms No absolute contraindications Not on antidepressants (except small dose of amitriptyline) for at least 2 weeks Can be done at sites across UK or remotely (including medication delivery) Scales and questionnaires, optional add on studies (blood or blood spot tests; wearables) 8-week to primary endpoint; follow-up for one year for disease modification

5. ADEpT-PD trial

6. Participate in the ADepT-PD trial: Websites with further contact information https://www.ucl.ac.uk/comprehensive-clinical-trials-unit/research-projects/2021/jun/adept-pd Trial website: https://www.ucl.ac.uk/comprehensive-clinical-trials-unit/research-projects/2021/jun/adept-pd Trial This also has all the open sites with contact information Cure Parkinson s Trust Cure Parkinson s Trust (they are supporting the trial together with the NIHR): https://cureparkinsons.org.uk/2020/12/the-adept-pd-trial/ email General contact for the trial team for any queries: email us at: neuro.adept@ucl.ac.uk Beck-Depression-Inventory-and-Scoring-Key1.pdf (squarespace.com) Key screening criterion: BDI score 14 or more, e.g. Beck-Depression-Inventory-and-Scoring-Key1.pdf (squarespace.com)

7. Aim: Investigate the mechanisms of Anxiety in Parkinsons Key inclusion criteria: Anyone with Parkinson s who would be interested in participating. Comparison groups: PD with Anxiety vs PD without Anxiety; small control group Remote (or in person) assessment of clinical features; behavioural tasks, cognition One-year follow up Optional MRI study at Queen Square Institute of Neurology Physiological measures of anxiety (cortisol levels, heart rate, skin conductance) Qualitative interviews on experiences of anxiety and its treatment Contact for queries or interested patients: and-pd@ucl.ac.uk Anxiety in Parkinson s study (AND- PD)

8. What are the experiences Experiences with Anxiety in Parkinson s What are the most difficult problems Heterogeneity: e.g. panic attacks, relationship to PD, changes over time Recognising and diagnosing anxiety or depression Treatment experiences (including psychological treatments) and questions you think are important:

9. To develop and test a new resource to help those with Parkinson's self-manage their care; and supported by specially trained health care professionals. Six work packages over a 5 year period: Evidence synthesis & qualitative work Co-design and User testing to develop toolkit Feasibility study Randomised control trial of effectiveness and cost effectiveness Process evaluation Dissemination PD PD- -Care Care Project Project

10. PD-Care: The Live Well with Parkinsons Self- management Toolkit MY SYMPTOMS FOR MONITORING OR REVIEWING AS WELL AS PERSONALISED INFORMATION MY WELL-BEING TO IDENTIFY LIFE PRIORITIES AND CREATE STEPS MY TRACKER TO TRACK SYMPTOMS, MEDICATIONS AND ACTIVITIES 68 INFORMATION SECTIONS (WITH OPTION TO TAILOR: MY INFORMATION ) OTHERS CAN BE GIVEN ACCESS TO TOOLKIT (E.G., CARER OR HCP) SIX SESSIONS WITH A SUPPORTER ONLINE OR PAPER VERSION

11. Please contact Megan Armstrong or Tasmin Rookes for more information: pd-care@ucl.ac.uk Participate in PD-Care https://www.youtube.com/watch?v=g xpg22FT8wU

12. Please contact us if you are interested in either of these studies: Quantitative study of Anxiety symptoms (mainly remote), with or without MRI, genetic and/or biomarker studies (in person) Treatment trial of nortriptyline/escitalopram for low mood/progression of Parkinson s Interviews about experiences with Anxiety in Parkinson s PD-Care/Live well with Parkinson s Supported Self- Management trial Consideration of one of the other studies Contact: movementdisorders@ucl.ac.uk

13. Providing support to coordinate and plan future care: PD-Pal trial rf-tr.pd-pal@nhs.net rf-tr.pd-pal@nhs.net Ondansetron for Parkinson s and hallucinations: TOPHAT trial Other studies (requiring face-to-face assessments) Rivastigmine for Parkinson s and falls: CHIEF-PD Upcoming: Parkinson s and cognitive impairment: COBALT study Validation of self-completed MDS-NMS version

14. Contact: movementdisorders@ucl.ac.uk ADepT-PD: neuro.adept@ucl.ac.uk AND-PD: And-pd@ucl.ac.uk PD-Care: pd-care@ucl.ac.uk PD-Pal: rf-tr.pd-pal@nhs.net