Non-Motor Symptoms of Parkinson's Disease

While Parkinson’s is characterized by slowness of movement, rigidity, tremor and postural instability, many people with Parkinson’s may experience other changes; sometimes even prior to their motor symptoms. These other changes, known as non-motor symptoms, can also impact one’s quality of life and many patients may not realize that these other symptoms are linked to Parkinson’s disease. As a result, these non-motor symptoms often go untreated.

Non-motor symptoms can vary substantially from patient to patient and can include the following*: drooling; change in taste and smell; choking and swallowing difficulties; nausea and vomiting; constipation; uncontrolled loss of stool; bladder dysfunction; unexplained changes in weight; dementia and cognitive impairment; hallucinations; depression and anxiety; sexual dysfunction, orthostatic hypotension; excessive daytime sleepiness; insomnia; REM sleep behaviour disorder; restless leg syndrome; leg swelling; excessive sweating; double vision; delusions and impulse control disorders. 

Parkinson Canada funded researcher Dr. Ron Postuma, developed two tools help people with Parkinson’s and their physicians identify and manage non-motor symptoms: 'A Guide to the Non-Motor Symptoms of Parkinson’s Disease’ (for people with Parkinson’s) and the Physician Guide to Non-motor symptoms of Parkinson’s Disease. Both these guides include the internationally-validated PD NMS Questionnaire (PDF) so patients can record what they are experiencing and discuss the symptoms with their doctor.

*Source: A Guide to the Non-Motor Symptoms of Parkinson’s Disease by Ron Postuma & Christos Galatas

Depression and Parkinson’s disease

Depression is one of the common non-motor symptoms of Parkinson’s disease; with as many as 50 per cent of people with Parkinson’s experiencing the symptoms of clinical depression at some stage of the disease.

Although living with Parkinson’s can certainly be challenging, and the diagnosis can be frightening at first, depression in people with Parkinson’s may be caused by the chemical and physical changes in the area of the brain that affect mood, as well as movement. In fact, depression may be an early symptom of the disease, with some people experiencing depression up to a decade or more before experiencing any motor symptoms of Parkinson’s.

Depression can be one of the most disabling symptoms of the disease. But, it is important to know it can be treated. As much as possible, remain socially engaged and physically active. Resist the urge to isolate yourself. You may want to consult a psychologist and there are medications that help relieve depression in people with Parkinson’s, including nortriptyline and citalopram (Celexa.)

For more information, refer to our Guide to the Non-Motor Symptoms of Parkinson’s Disease.

For information and support on living well with Parkinson's disease, call our toll-free Information and Referral line at 1-800-565-3000 or contact a regional office near you.

It is important to remember that clinical depression and anxiety are underdiagnosed in people with Parkinson's and that they are symptoms of your disease. Researchers believe that depression and anxiety in Parkinson's disease may be due to underlying changes in brain chemistry that are caused by the disease itself. In fact, depression in Parkinson's patients can start before motor symptoms even arise.

People with Parkinson’s, family members and caregivers may not always recognize the signs of depression and anxiety. In fact, your physician may not even ask you about these conditions if you don't mention changes in mood. Complete the Parkinson Canada’s Geriatric Depression Scale-15 to record your feelings so you can discuss symptoms with your doctor.