title: Antidepressant treatment of veterans with Parkinson's disease and depression: analysis of a national sample.
abstract: We examined the impact of comorbid Parkinson's disease (PD) on depression treatment. Using national Veterans Affairs (VA) databases, fiscal year 2002 data were examined for 283 273 elderly males seen for depression. We compared 2 matched depression groups, one with (N = 7868) and one without (N = 7868) PD. In the 12-month period following a depression-related clinic visit, PD and non-PD patients were equally likely to fill an antidepressant prescription (77.8% vs. 77.4%), most commonly for a selective serotonin re-uptake inhibitor (SSRI) (62.9% vs 62.6%). Depressed PD patients had slightly higher rates of newer non-SSRI use (20.6% vs 19.2%, P < .05) and lower rates of tricyclic antidepressant use (7.4% vs 8.9%, P < .001). The presence of a PD diagnosis appears to have little impact on the frequency and type of antidepressant treatment. Efforts to improve the care of depressed PD patients should focus instead on improving recognition, ensuring adequacy of treatment, and evaluating the efficacy of existing antidepressants.
authors: Division of Geriatric Psychiatry, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA. Peijun.chen@med.va.gov
authors: Peijun
authors: P
authors: Chen
authors: Helen C
authors: HC
authors: Kales
authors: Daniel
authors: D
authors: Weintraub
authors: Frederic C
authors: FC
authors: Blow
authors: Lan
authors: L
authors: Jiang
authors: Alan M
authors: AM
authors: Mellow
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology*
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
references: J Neuropsychiatry Clin Neurosci. 2001 Spring;13(2):187-96
references: 11449025
references: Mov Disord. 2000 Mar;15(2):216-23
references: 10752569
references: Neurology. 1997 Apr;48(4):1070-7
references: 9109902
references: JAMA. 2002 Dec 11;288(22):2836-45
references: 12472325
references: J Neurol Neurosurg Psychiatry. 1992 May;55(5):377-82
references: 1602311
references: Am J Psychiatry. 1992 Apr;149(4):443-54
references: 1372794
references: Mov Disord. 1988;3(3):237-44
references: 2461509
references: J Am Geriatr Soc. 2004 May;52(5):784-8
references: 15086662
references: J Geriatr Psychiatry Neurol. 2003 Sep;16(3):178-83
references: 12967062
references: Psychiatr Serv. 2003 Sep;54(9):1233-9
references: 12954939
references: JAMA. 2003 Jun 18;289(23):3145-51
references: 12813120
references: Clin Neuropharmacol. 2003 May-Jun;26(3):142-5
references: 12782916
references: Mov Disord. 2005 Sep;20(9):1161-9
references: 15954137
references: Am J Psychiatry. 2005 Apr;162(4):718-24
references: 15800144
references: Neurology. 1997 Oct;49(4):1168-70
references: 9339713
references: Arch Neurol. 1995 Jul;52(7):695-701
references: 7619026