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

Richard, Irene Hegeman; McDermott, M. P.; Kurlan, Roger; Lyness, Jeffrey M.; Como, Peter; Pearson, Nancy; Factor, Stewart A.; Juncos, Jorge L.; Ramos, Carmen Serrano; Brodsky, Matthew; Manning, Carol A.; Marsh, Laura; Shulman, Lisa M.; Fernández, Hubert H.; Black, Kevin J.; Panisset, Michel; Christine, Chadwick W.; Jiang, Wei; Singer, Carlos; Horn, Sarah R.; Pfeiffer, Ronald F.; Rottenberg, David A.; Slevin, John T.; Elmer, Lawrence; Press, Daniel Z.; Hyson, H. Christopher; McDonald, William M.

doi:10.1212/wnl.0b013e3182516244

Cited by 294 publications

(230 citation statements)

References 34 publications

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“…In two randomized trials comparing bilateral STN DBS with best medical therapy at 6-month follow-up, results correspond to an improvement of 17% and 25% in both DBS series, with almost no change in the medication groups (23,24). In other studies improvement of up to 68% has been reported in PDQ-39 at up to 24 months of follow up (13,21,11,20). Interestingly, an improvement in QoL in pallidal and subthalamic DBS after 2 years in a randomized trial was only moderate and reached 11.2% and 8.9% respectively (7).…”

Section: Disclosurementioning

confidence: 78%

Quality of life and depressive symptoms in parkinson's disease after subthalamic deep brain stimulation. a 2-year follow-up study

Tykocki¹,

Szalecki²,

Koziara³

et al. 2012

Turkish Neurosurgery

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AIm:To assess the correlation between quality of life (QoL), depressive symptoms and motor signs in patients with Parkinson disease after subthalamic deep brain stimulation (DBS STN). mAterIAl and methOds: 74 patients, average age 55.6 ± 7 and duration of disease 12.3 years± 3.8, treated with l STN DBS for PD were included in the study. All patients were evaluated with (UPDRS III), (PDQ-39) (BDI) at baseline and at 6, 12, and 24-month follow up. All patients were also stratified into three groups depending on UPDRS III improvement (<30%, 30-60%, >60%). BulGulAr: Tüm ölçeklerdeki puanlar başlangıca göre önemli ölçüde azaldı. PDQ-39'daki iyileşme 6 ayda %43,3 BDI'da %25,3 ; UPDRS-III %55,5 bulundu. 24 ayda motor sonuçlar QoL sırasıyla %15,6 ve %19,6 bozuldu. BDI değişmeden kaldı. PDQ-39 için başlangıçtaki ortalama skorlar grup I'da 67,4 ± 29,7; II 64,8±32,0; III 53,4±22,0 ve BDI için, grup I'de 17,4±12,04; II 14,0±9,7; III-15,1±10,55. Puanlar 6 aylık takipte DBS'de önemli ölçüde azaldı ve ortalama değişim şöyleydi: PDQ-39, grup I %42,7, II-%40,7, III %51,6; BDI grup I %23, II %28,1, III %23,3. sOnuÇ: DBS STN sonrasında PD'de depresif belirtiler, motor bulgularda azalma ve QoL'de artış yakından ilişkilidir. QoL artışı önemli ölçüde motor belirtilere bağlıdır.

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Section: Disclosurementioning

confidence: 78%

Quality of life and depressive symptoms in parkinson's disease after subthalamic deep brain stimulation. a 2-year follow-up study

Tykocki¹,

Szalecki²,

Koziara³

et al. 2012

Turkish Neurosurgery

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“…Therefore, in most cases, MAO-B inhibitors can be safely administered along with SSRIs. This is important because the co-morbidity of depression and PD makes it quite likely that an SSRI will be required at some point during the disease course [43][44][45]. Discontinuing a MAO-B inhibitor in order to start an SSRI or using an alternative class of antidepressant to avoid interaction is generally not necessary as long as the recommended dose of MAO-B inhibitor is not exceeded.…”

Section: Safety Of Mao-b Inhibitorsmentioning

confidence: 99%

Defining the Role of the Monoamine Oxidase-B Inhibitors for Parkinson’s Disease

Robakis

Fahn

2015

CNS Drugs

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Inhibitors of monoamine oxidase-B (MAO-B) occupy an important place in the treatment of Parkinson's disease. Selegiline was the first MAO-B to be used therapeutically, while rasagiline is a second-generation drug with higher potency and selectivity. Safinamide is an investigational MAO-B inhibitor with non-dopaminergic properties that may provide advantages over its predecessors. As a class, MAO-B inhibitors are safe and well tolerated and provide symptomatic benefit both as monotherapy and in combination with other antiparkinsonian medications from early to late stages of disease. In combination with levodopa, MAO-B inhibitors may improve motor fluctuations and allow for lower total doses of levodopa. Patient characteristics and preferences can be important factors in deciding between agents. As a class, MAO-B inhibitors have shown promise as disease-modifying agents, but the clinical trial evidence to date has not been strong enough to afford them such a label. Future research may help further elucidate their relative merits and clarify their role in altering disease progression. Key PointsRasagiline and selegiline are two monoamine oxidase-B (MAO-B) inhibitors commonly used in the treatment of Parkinson's disease (PD), while safinamide is an investigational agent of the same class.MAO-B inhibitors are safe, with few serious side effects, and provide mild but worthwhile improvements in the motor symptoms of PD, either as monotherapy or adjunctive to levodopa.The possibility that MAO-B inhibitors could slow down the progression of PD has been suggested by some studies but not by others and remains an open question.

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“…Paroxetine and Venlafaxine are both effective to decrease the depression in patients with Parkinson's disease. [46] Antipsychotics in Parkinson's disease: Psychosis, hallucination and confusion are common problems in patients with Parkinson's disease treated with long-term dopaminergic treatment. Clozapine, an atypical antipsychotic is effective to control drug-induced psychosis and tremor in Parkinson's disease [47].…”

Section: Antidepressant In Parkinson Diseasementioning

confidence: 99%

A Review on Pharmacological Treatment of Idiopathic Parkinson’s Disease

Shah¹

2017

Journal of Neurological Disorders

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

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

Cited by 294 publications

References 34 publications

Quality of life and depressive symptoms in parkinson's disease after subthalamic deep brain stimulation. a 2-year follow-up study

Quality of life and depressive symptoms in parkinson's disease after subthalamic deep brain stimulation. a 2-year follow-up study

Defining the Role of the Monoamine Oxidase-B Inhibitors for Parkinson’s Disease

A Review on Pharmacological Treatment of Idiopathic Parkinson’s Disease

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