Table 3.

Interventions to treat apathy in PD

Intervention
Drug class/intervention strategy	Drug/intervention	Efficacy	Safety	Practice implications
Dopamine agonists	Piribedil a	Likely efficacious	Acceptable risk without specialized monitoring	Possibly useful
	Rotigotine	Unlikely efficacious	Acceptable risk without specialized monitoring	Investigational
Acetylcholinesterase inhibitors	Rivastigmine	Efficacious	Acceptable risk without specialized monitoring b	Possibly useful

^aRecommendations apply only for PD patients following STN stimulation.

^bWorsening of tremor may occur in some patients treated with cholinesterase inhibitors. Medical monitoring for cholinergic effects could include blood pressure or electrocardiograph monitoring but acetylcholinesterase inhibitors are considered to pose an acceptable risk even without specialized monitoring.2