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All Journal Journal of Clinical and Cultural Psychiatry Indian Journal of Forensic Medicine & Toxicology
Risza Subiantoro
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Medicine & Pharmacology Public Health

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A 56 Year Old Man with Parkinson’s Disease and Depression: A Case Report on Treatment Management Risza Subiantoro; Agustina Konginan; Erikavitri Yulianti
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 4 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i4.17046

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 tothinking 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 diagnosedwith PD 8 years previously and was on medication. One month before the visit, the patient underwent athalamotomy operation. After surgery, the patient received therapy in the form of a combination tabletof levodopa/carbidopa/entacapaone (100/25/200 mg) 4×1 tablet and 1×2 mg of ropirinole. On the BeckDepression Inventory (BDI) examination, a score of 23 was obtained and on the Montgomery AsbergDepression Rating Scale (MADRS) examination a score of 31 was obtained, both of which correspond tomajor depression. The patient was diagnosed with a major depressive episode without psychotic symptomsand was given escitalopram therapy 1×10 mg and lorazepam 1×2 mg. Patients also received biofeedbacktherapy with family psychoeducation and supportive psychotherapy. At the time of control, the patientadmitted to feeling calmer and able to sleep after receiving therapy. Conclusion: Escitalopram has goodefficacy for the management of depression in PD patients.
Early Detection of Post-Operating Depression Risza Subiantoro
Journal of Clinical and Cultural Psychiatry Vol 4 No 1 (2023)
Publisher : Indoscholar Publication and the Indonesian Psychiatric Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/jccp.v2i2.29

Abstract

A significant depressed episode called postoperative delayed paradoxical depression interferes with the disease's medical management and treatment. Because it occurred following a successful intervention, yet the patient didn't feel relieved, it is considered paradoxical. Often regarded as a mild variant of post-traumatic stress disorder, is said to be delayed due to the manifestation of several weeks after surgery. Anomalies or dysregulation of aminobiogenic metabolites, including norepinephrine, dopamine, and serotonin, are present in patients with mood disorders. The neurotransmitters norepinephrine, dopamine, and serotonin are reduced in depressive situations. Neurotransmitter norepinephrine controls mood, appetite, reward behavior, arousal, and drive. A neurotransmitter called dopamine controls motivation, pleasure, sex, and psychomotor function. Psychopharmaceuticals, psychotherapy, and neurostimulation are some of the therapeutic methods available for depression therapy. Serotonin and norepinephrine are increased at the postsynaptic level by SNRIs by blocking their reuptake. Besides psychopharmaceuticals approach, other methods include antidepressants, re-education, and psychotherapy are required.
Co-Authors Konginan, Agustina Yulianti, Erikavitri