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Neurology. 2012 Apr 17;78(16):1229-36. doi: 10.1212/WNL.0b013e3182516244. Epub 2012 Apr 11.

A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease.

Author information

  • 1University of Rochester, Rochester, NY, USA. Irene_Richard@urmc.rochester.edu

Abstract

OBJECTIVE:

To evaluate the efficacy and safety of a selective serotonin reuptake inhibitor (SSRI) and a serotonin and norepinephrine reuptake inhibitor (SNRI) in the treatment of depression in Parkinson disease (PD).

METHODS:

A total of 115 subjects with PD were enrolled at 20 sites. Subjects were randomized to receive an SSRI (paroxetine; n = 42), an SNRI (venlafaxine extended release [XR]; n = 34), or placebo (n = 39). Subjects met DSM-IV criteria for a depressive disorder, or operationally defined subsyndromal depression, and scored >12 on the first 17 items of the Hamilton Rating Scale for Depression (HAM-D). Subjects were followed for 12 weeks (6-week dosage adjustment, 6-week maintenance). Maximum daily dosages were 40 mg for paroxetine and 225 mg for venlafaxine XR. The primary outcome measure was change in the HAM-D score from baseline to week 12.

RESULTS:

Treatment effects (relative to placebo), expressed as mean 12-week reductions in HAM-D score, were 6.2 points (97.5% confidence interval [CI] 2.2 to 10.3, p = 0.0007) in the paroxetine group and 4.2 points (97.5% CI 0.1 to 8.4, p = 0.02) in the venlafaxine XR group. No treatment effects were seen on motor function.

CONCLUSIONS:

Both paroxetine and venlafaxine XR significantly improved depression in subjects with PD. Both medications were generally safe and well tolerated and did not worsen motor function.

CLASSIFICATION OF EVIDENCE:

This study provides Class I evidence that paroxetine and venlafaxine XR are effective in treating depression in patients with PD.

Comment in

  • Glad about SAD (PD). [Neurology. 2012]
PMID:
22496199
[PubMed - indexed for MEDLINE]
PMCID:
PMC3324323
Free PMC Article
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