What is your preferred first-line agent to treat anxiety in patients with Parkinson's disease?

Any standard SSRI/SNRI can be tried. I like to try the SNRIs duloxetine or venlafaxine.

If comorbid insomnia is a problem, mirtazapine may be a good choice.

Think about talk therapy too.

It is important to make sure episodic anxiety is not a non-motor symptom fluctuation related to levodopa or oth...

You can try hydroxyzine as it has some anti-anxiety effects without the anticholinergic effects. You could also try low-dose quetiapine 25 mg as it won't bind the D2 receptor that much.

I am not opposed to BZD use. I think they have been unfairly maligned. I do think one needs to assess whether that individual has a potential for misuse, and they need to be monitored for the development of tolerance. I would not use them if there is any evidence of cognitive dysfunction in a Parkin...