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

I. H. Richard, M. P. McDermott, R. Kurlan, J. M. Lyness, P. G. Como, N. Pearson, S. A. Factor, J. Juncos, C. Serrano Ramos, M. Brodsky, C. Manning, L. Marsh, L. Shulman, H. H. Fernandez, K. J. Black, M. Panisset, C. W. Christine, W. Jiang, Carlos Singer, S. HornR. Pfeiffer, D. Rottenberg, J. Slevin, L. Elmer, D. Press, H. C. Hyson, W. McDonald

Research output: Contribution to journalArticle

166 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1229-1236
Number of pages8
JournalNeurology
Volume78
Issue number16
DOIs
StatePublished - Apr 17 2012

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Paroxetine
Antidepressive Agents
Parkinson Disease
Placebos
Depression
Serotonin Uptake Inhibitors
Confidence Intervals
Social Adjustment
Depressive Disorder
Diagnostic and Statistical Manual of Mental Disorders
Therapeutics
Maintenance
Outcome Assessment (Health Care)
Venlafaxine Hydrochloride
Controlled
Placebo
Antidepressants
Parkinson's Disease
Safety

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Richard, I. H., McDermott, M. P., Kurlan, R., Lyness, J. M., Como, P. G., Pearson, N., ... McDonald, W. (2012). A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease. Neurology, 78(16), 1229-1236. https://doi.org/10.1212/WNL.0b013e3182516244

A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease. / Richard, I. H.; McDermott, M. P.; Kurlan, R.; Lyness, J. M.; Como, P. G.; Pearson, N.; Factor, S. A.; Juncos, J.; Ramos, C. Serrano; Brodsky, M.; Manning, C.; Marsh, L.; Shulman, L.; Fernandez, H. H.; Black, K. J.; Panisset, M.; Christine, C. W.; Jiang, W.; Singer, Carlos; Horn, S.; Pfeiffer, R.; Rottenberg, D.; Slevin, J.; Elmer, L.; Press, D.; Hyson, H. C.; McDonald, W.

In: Neurology, Vol. 78, No. 16, 17.04.2012, p. 1229-1236.

Research output: Contribution to journalArticle

Richard, IH, McDermott, MP, Kurlan, R, Lyness, JM, Como, PG, Pearson, N, Factor, SA, Juncos, J, Ramos, CS, Brodsky, M, Manning, C, Marsh, L, Shulman, L, Fernandez, HH, Black, KJ, Panisset, M, Christine, CW, Jiang, W, Singer, C, Horn, S, Pfeiffer, R, Rottenberg, D, Slevin, J, Elmer, L, Press, D, Hyson, HC & McDonald, W 2012, 'A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease', Neurology, vol. 78, no. 16, pp. 1229-1236. https://doi.org/10.1212/WNL.0b013e3182516244
Richard IH, McDermott MP, Kurlan R, Lyness JM, Como PG, Pearson N et al. A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease. Neurology. 2012 Apr 17;78(16):1229-1236. https://doi.org/10.1212/WNL.0b013e3182516244
Richard, I. H. ; McDermott, M. P. ; Kurlan, R. ; Lyness, J. M. ; Como, P. G. ; Pearson, N. ; Factor, S. A. ; Juncos, J. ; Ramos, C. Serrano ; Brodsky, M. ; Manning, C. ; Marsh, L. ; Shulman, L. ; Fernandez, H. H. ; Black, K. J. ; Panisset, M. ; Christine, C. W. ; Jiang, W. ; Singer, Carlos ; Horn, S. ; Pfeiffer, R. ; Rottenberg, D. ; Slevin, J. ; Elmer, L. ; Press, D. ; Hyson, H. C. ; McDonald, W. / A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease. In: Neurology. 2012 ; Vol. 78, No. 16. pp. 1229-1236.
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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.",
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T1 - A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease

AU - Richard, I. H.

AU - McDermott, M. P.

AU - Kurlan, R.

AU - Lyness, J. M.

AU - Como, P. G.

AU - Pearson, N.

AU - Factor, S. A.

AU - Juncos, J.

AU - Ramos, C. Serrano

AU - Brodsky, M.

AU - Manning, C.

AU - Marsh, L.

AU - Shulman, L.

AU - Fernandez, H. H.

AU - Black, K. J.

AU - Panisset, M.

AU - Christine, C. W.

AU - Jiang, W.

AU - Singer, Carlos

AU - Horn, S.

AU - Pfeiffer, R.

AU - Rottenberg, D.

AU - Slevin, J.

AU - Elmer, L.

AU - Press, D.

AU - Hyson, H. C.

AU - McDonald, W.

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N2 - 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.

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