Antidepressants Aid Depressed Parkinson's Patients
Two Classes of Medicine Help Depression in People With Parkinson's Without Worsening Other Symptoms, Experts Say
Treating Depression in Parkinson's Disease: Study Results
Patients in all three treatment groups, including the placebo group, showed improvement on a commonly used scale to gauge depression known as the Hamilton Rating Scale.
Those on antidepressants improved more than did those on placebo, Richard says.
On average, those getting Paxil had a 59% improvement. Those taking Effexor had a 52% improvement. Those who got the placebo had a 32% improvement.
Richard evaluated their depression using three other scales and found similar results.
There was no effect on movement ability.
Richard can't say which antidepressant type is better for treating depression in Parkinson's disease, she says. The study did not do a head-to-head comparison of the two types.
Each type, SSRI and SNRI, includes many different medicines, so patients have a choice, she says.
Both medicines studied are available as generics, Richard says. At the doses studied, the cost would be about $20 to $30 a month.
Patients reported side effects such as insomnia, constipation, sexual dysfunction, and fatigue. Three patients, including one in the placebo group, had serious side effects. These included chest pressure, bowel obstruction, and heart rhythm problems.
However, only the patient with heart rhythm problems withdrew.
Richard reports serving on the scientific advisory board for the Michael J. Fox Foundation. She has received a speaker honorarium from Teva Pharmaceutical Industries and research support from Neurologix, Inc., Eli Lilly and Company, Cornell University, and the Michael J. Fox Foundation.
Wyeth Pharmaceuticals provided the venlafaxine XR. Glaxo SmithKline provided the paroxetine.
Treating Depression in Parkinson's Disease: Perspective
The study has ''critical information" for patients and caregivers, says Michael S. Okun, MD, national medical director of the National Parkinson Foundation. He reviewed the findings.
"The bottom-line message is that treatment for depression in Parkinson's disease matters," he says. "An important aspect of this particular study was that it had a placebo group, and that the investigators showed that either antidepressant performed better than placebo for Parkinson patients."
An editorial that accompanies the study concludes that depression in Parkinson's patients may be as treatable as it is in the general population.