title: A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease.
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.
  
  
  METHODS
  This study provides Class I evidence that paroxetine and venlafaxine XR are effective in treating depression in patients with PD.
authors.affiliation: University of Rochester, Rochester, NY, USA. Irene_Richard@urmc.rochester.edu
authors.forename: I H
authors.initials: IH
authors.lastname: Richard
authors.forename: M P
authors.initials: MP
authors.lastname: McDermott
authors.forename: R
authors.initials: R
authors.lastname: Kurlan
authors.forename: J M
authors.initials: JM
authors.lastname: Lyness
authors.forename: P G
authors.initials: PG
authors.lastname: Como
authors.forename: N
authors.initials: N
authors.lastname: Pearson
authors.forename: S A
authors.initials: SA
authors.lastname: Factor
authors.forename: J
authors.initials: J
authors.lastname: Juncos
authors.forename: C
authors.initials: C
authors.lastname: Serrano Ramos
authors.forename: M
authors.initials: M
authors.lastname: Brodsky
authors.forename: C
authors.initials: C
authors.lastname: Manning
authors.forename: L
authors.initials: L
authors.lastname: Marsh
authors.forename: L
authors.initials: L
authors.lastname: Shulman
authors.forename: H H
authors.initials: HH
authors.lastname: Fernandez
authors.forename: K J
authors.initials: KJ
authors.lastname: Black
authors.forename: M
authors.initials: M
authors.lastname: Panisset
authors.forename: C W
authors.initials: CW
authors.lastname: Christine
authors.forename: W
authors.initials: W
authors.lastname: Jiang
authors.forename: C
authors.initials: C
authors.lastname: Singer
authors.forename: S
authors.initials: S
authors.lastname: Horn
authors.forename: R
authors.initials: R
authors.lastname: Pfeiffer
authors.forename: D
authors.initials: D
authors.lastname: Rottenberg
authors.forename: J
authors.initials: J
authors.lastname: Slevin
authors.forename: L
authors.initials: L
authors.lastname: Elmer
authors.forename: D
authors.initials: D
authors.lastname: Press
authors.forename: H C
authors.initials: HC
authors.lastname: Hyson
authors.forename: W
authors.initials: W
authors.lastname: McDonald
mesh_terms: D018759:Adrenergic Uptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003511:Cyclohexanols / Q000008:administration & dosage / Q000627:therapeutic use*; D003692:Delayed-Action Preparations / Q000009:adverse effects / Q000627:therapeutic use; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D017374:Paroxetine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012720:Severity of Illness Index; D000069470:Venlafaxine Hydrochloride
chemical_list: D018759:Adrenergic Uptake Inhibitors; D000928:Antidepressive Agents; D003511:Cyclohexanols; D003692:Delayed-Action Preparations; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride