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

Richard IH et al. – Both paroxetine and venlafaxine extended release (venlafaxine XR) significantly improved depression in subjects with Parkinson disease (PD). Both medications were generally safe and well tolerated and did not worsen motor function.

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.

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