Antidepressive Treatments for Parkinson's Disease: A Systematic Review and Meta-Analysis

Prevalence, impact, and management of depression and anxiety in patients with Parkinson’s disease

“…These results were generally consistent with two other recent meta-analyses of pharmacological treatment of depression in PD, suggesting superiority of TCAs to SSRIs in reducing PD depression symptoms. 61,62 In contrast to Troeung et al's 60 findings, Bomasang-Layno et al 59 did not find a significant effect of TCAs in the treatment of depression in PD but found that when stratifying SSRI/SNRI treatments versus other pharmacological treatments, the SSRI/SNRI treatment studies showed a significant effect on depressive symptoms in PD. Of note, Troeung et al 60 also caution that the nonsignificant treatment effect in SSRIs may be due to the limited number of randomized controlled trials (RCTs) included for analysis (N=5) and highlighted the need for additional, carefully designed studies.…”

“…Indeed, several small, controlled trials using selective serotonin reuptake inhibitors (SSRIs) failed to show efficacy in PD depression, although a recent meta-analysis showed significant effect of antidepressant treatment on depressive symptoms in PD when SSRI and serotonin-norepinephrine reuptake inhibitors (SNRI) treatment studies were combined. [57][58][59] Troeung et al 60 recently published a meta-analysis of randomized, placebo-controlled trials for the treatment of anxiety and depression in PD. Of note, this analysis was limited to PD patients who met DSM criteria for depressive or anxiety disorder.…”

“…59, 60 Dobkin et al 66 used a cognitive behavioral therapy (CBT) approach specifically tailored for Parkinson patients in the treatment group (N=41), compared to a clinical monitoring control group (N=39). Those in the CBT group showed greater reduction in depressive symptoms (56% responders, characterized by a greater than 50% decrease in depressive symptoms) compared to the control group (8% responders).…”

“…83,84 Interestingly, ECT has been observed to also improve motor symptoms in these patients. However, the existing literature on ECT in PD patients consists only of case studies; 59 therefore, more research in the form of RCTs is needed before ECT would be a recommended therapy for psychiatric symptoms in PD.…”

The assessment of pharmacoeconomic studies quality of Levodopa’s use for the management of Parkinson’s diseases, 2010-2015

“…Accordingly, it is necessary to identify the use of LP in the PD's treatment and to determine the pharmacoeconomic studies' quality that has been done in the last five years. In the literature exists multiple systematic reviews of Parkinson's disease and others associated with the disease treatment [14][15][16][17][18][19][20][21]. But, there are not quality evaluations of the publication's methodology focused on cost-utility studies of the LD used in the EP treatment.…”