In treating Parkinson's disease with depression, which class of antidepressants should clinicians be cautious of due to the potential for side effects on cognition?

Tricyclic antidepressants are associated with potential side effects that can significantly impact cognition, particularly in patients with Parkinson's disease. Due to their anticholinergic properties, tricyclics can lead to confusion, memory impairment, and sedation, which are already prevalent concerns in Parkinson's patients who may have underlying cognitive issues. Since these side effects can exacerbate the cognitive decline associated with Parkinson’s disease, clinicians need to exercise caution when prescribing this class of medications.

While benzodiazepines, SSRIs, and SNRIs can also have side effects, they generally have a more favorable profile regarding cognitive function. Benzodiazepines can cause sedation and may impair memory, but they are typically not first-line treatments for depression. SSRIs and SNRIs tend to be better tolerated and are often preferred due to their lower risk of cognitive impairment compared to tricyclic antidepressants. Thus, the cognitive risks associated with tricyclics make them the class of antidepressants that clinicians should be particularly cautious of in the context of treating Parkinson's disease with depression.