title: Severity of depression and anxiety are predictors of response to antidepressant treatment in Parkinson's disease.
abstract: BACKGROUND
  Antidepressants have appeared to be more effective than placebo treatment in treating depressive syndromes in patients with Parkinson's disease (PD).
  
  
  OBJECTIVE
  To identify factors that predict improvement in depressive symptoms during antidepressant treatment in depressed PD patients.
  
  
  METHODS
  A secondary analysis was performed on the dataset of the Randomized Placebo-controlled Study of Antidepressants in PD (SAD-PD), in which 76 patients received active treatment with either paroxetine or venlafaxine extended release (XR), and 39 patients received placebo treatment. Backward stepwise regression analyses were conducted with change in 24-item Hamilton Depression Rating Scale (HAMD-24) score between assessments at baseline and week 12 as the main outcome measure, and sex, age, baseline HAMD-24 score, Unified Parkinson's Disease Rating Scale section III (UPDRS-III) score, Mini-Mental State Examination (MMSE), and the Clinical Anxiety Scale (CAS) as independent variables.
  
  
  RESULTS
  In both the active treatment and placebo groups, higher baseline HAMD-24 score and lower UPDRS-III score were associated with greater reduction in HAMD-24 score. Higher anxiety scores predicted less response in the active treatment group. Higher MMSE scores predicted greater response only in the placebo-treated group. Sex and age were no predictors of response.
  
  
  CONCLUSIONS
  Higher pre-treatment depression scores and lower pre-treatment anxiety scores are the two most important predictors for improvement during antidepressant treatment in depressed PD patients, which is in line with those found in treatment studies of depressed non-PD patients. Furthermore, our results indicate the requirement for different or more intensive treatment for depressed PD patients with more severe anxiety symptoms.
authors.affiliation: Department of Psychiatry, Maastricht University, Maastricht, The Netherlands. Electronic address: anja.moonen@maastrichtuniversity.nl.
authors.forename: A J H
authors.initials: AJ
authors.lastname: Moonen
authors.affiliation: Department of Psychiatry, Maastricht University, Maastricht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Wijers
authors.affiliation: Department of Psychiatry, Maastricht University, Maastricht, The Netherlands.
authors.forename: A F G
authors.initials: AF
authors.lastname: Leentjens
authors.affiliation: Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: C W
authors.initials: CW
authors.lastname: Christine
authors.affiliation: Department of Neurology, Emory University, Atlanta, GA, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Factor
authors.affiliation: Department of Neurology, Emory University, Atlanta, GA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Juncos
authors.affiliation: University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Lyness
authors.affiliation: Mental Health Care Line, Michael E. DeBakey Veterans Administration Medical Center, Houston, USA; Department of Psychiatry, Baylor College of Medicine, Houston, USA; Department of Neurology, Baylor College of Medicine, Houston, USA.
authors.forename: L
authors.initials: L
authors.lastname: Marsh
authors.affiliation: Department of Neurology, University of Montreal, Montreal, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Panisset
authors.affiliation: Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
authors.forename: R
authors.initials: R
authors.lastname: Pfeiffer
authors.affiliation: Department of Neurology, University of Minnesota, Minneapolis, MN, USA; Department of Radiology, University of Minnesota, Minneapolis, MN, USA.
authors.forename: D
authors.initials: D
authors.lastname: Rottenberg
authors.affiliation: University of Puerto Rico School of Medicine, Puerto Rico.
authors.forename: C
authors.initials: C
authors.lastname: Serrano Ramos
authors.affiliation: Department of Neurology, University of Maryland School of Medicine, Baltimore, USA.
authors.forename: L
authors.initials: L
authors.lastname: Shulman
authors.affiliation: Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: C
authors.initials: C
authors.lastname: Singer
authors.affiliation: Department of Neurology, University of Kentucky College of Medicine, Lexington, KY, USA.
authors.forename: J
authors.initials: J
authors.lastname: Slevin
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.
authors.forename: W
authors.initials: W
authors.lastname: McDonald
authors.affiliation: University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
authors.forename: P
authors.initials: P
authors.lastname: Auinger
authors.affiliation: University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
authors.forename: I H
authors.initials: IH
authors.lastname: Richard
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy*; D003511:Cyclohexanols / Q000627:therapeutic use*; D066264:Datasets as Topic; D003863:Depression / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D017374:Paroxetine / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D000069470:Venlafaxine Hydrochloride
chemical_list: D000928:Antidepressive Agents; D003511:Cyclohexanols; D017374:Paroxetine; D000069470:Venlafaxine Hydrochloride
keywords: Clinical trials randomized controlled; Depression; Parkinson's disease; Paroxetine; Venlafaxine