Table 1 Neuropsychiatric and early PD/pre-PD treatments

Anxiety

Benzodiazepines (diazepam, lorazepam)

Lead to chronic stress that can worsen NMS

-

-

Further gut-brain axis modulation (gut microbiota with Lactobacillus plantarum PS128)

Cognitive impairment

Donepezil, galantamine, rivastigmine

Development of dementia

BMSC

Intravenous infusion

Increased adverse events (accidental falls, cognitive deterioration) with antipsychotics

Depression

Cognitive behavioral therapy, pramipexole, repetitive transcranial magnetic stimulation, venlafaxine

Prolongation of the Q-T interval when citalopram exceeds 20 mg in patients over 60 years old

NSC

Intravenous infusion

Sertraline, paroxetine, fluoxetine, citalopram with mild adverse reactions, contraindicated with monoamine oxidase B inhibitors MAO-BI. ECG monitoring is recommended

Hippocampal/NSC neurogenic compound NSI-189

Psychosis

Clozapine, pimavanserin

-

UC-MSC

Intravenous infusion

Regular blood routine monitoring is required

Impulse control disorder

Cognitive behavioral therapy

-

-

-

Dopamine agonist withdrawal syndrome should be monitored

Indifference

Piribedil

Comorbid depression, caregiver burden

-

-

Monitor patients for apathy after subthalamic nucleus deep brain stimulation surgery

Orthostatic hypotension

Droxidopa, fludrocortisone, midodrine

-

-

-

Moderate the use of diuretics, antidepressants, etc

Chronic constipation

Polyethylene glycol, probiotics/prebiotic fiber

-

Fecal microbiota transplantation

Upper gastrointestinal tract via nasoenteric tubes

Gut microbiota with probiotic supplements [8]

Anorexia, nausea, vomiting

Domperidone

-

-

-

Electrocardiogram needs to be monitored

Salivation

Ultrasound-guided botulinum toxin type A/B the injection to parotid gland/ submandibular gland

-

-

-

Chewing

Urinary dysfunction

Solifenacin

-

Myoblasts

Intrasphincteric injection

Anticholinergic (dry mouth, constipation) and non-cholinergic (indigestion, dizziness, headache) adverse reactions

Erectile dysfunction

Sildenafil

-

ASC

Intravenous infusion

Monitor orthostatic hypotension

Insomnia

Amantadine, eszopiclone, melatonin

-

-

-

Moderate the use of anti-PD drugs; continuous positive airway pressure for obstructive sleep apnea; further gut-brain axis modulation (gut microbiota with Lactobacillus fermentum PS150)

RBD

Clonazepam, melatonin

-

-

-

Moderate the use of SSRIs, SNRIs, TCAs, MAO-BI, or benzodiazepines

Pain

Opioids

-

-

-

Monitor constipation, gut microbiota with probiotic supplements, MSC-derived exosomes injection

Fatigue

Rasagiline

-

-

-

-