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Antidepressant studies in Parkinson's disease: A review and meta-analysis

Authors

  • Daniel Weintraub MD,

    Corresponding author
    1. Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    3. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
    4. Mental Illness Research, Education and Clinical Center (MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
    • 3535 Market St., Room 3003, Philadelphia, PA 19104
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  • Knashawn H. Morales ScD,

    1. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Paul J. Moberg PhD,

    1. Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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  • Warren B. Bilker PhD,

    1. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • Catherine Balderston MS,

    1. Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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  • John E. Duda MD,

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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  • Ira R. Katz MD, PhD,

    1. Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Mental Illness Research, Education and Clinical Center (MIRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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  • Matthew B. Stern MD

    1. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    2. Parkinson's Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
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Abstract

The objective of this study was to determine effect sizes for both antidepressant treatment and placebo for depression in Parkinson's disease (PD), and to compare the findings with those reported in elderly depressed patients without PD. Recent reviews have concluded that there is little empiric evidence to support the use of antidepressants in PD; however, available data has not been analyzed to determine the effect size for antidepressant treatment in PD depression. A literature review identified antidepressant studies in PD. Suitable studies were analyzed using meta-analytic techniques, and effect sizes were compared with those from antidepressant studies in elderly patients without PD. Large effect sizes were found for both active treatment and placebo in PD, but there was no difference between the two groups. In contrast, active treatment was superior to placebo in depressed elderly patients without PD. In PD, increasing age and a diagnosis of major depression were associated with better treatment response. Results also suggest that newer antidepressants are well tolerated in PD. Despite the high prevalence of depression and antidepressant use in PD, controlled treatment research has been almost nonexistent. Meta-analysis results suggest a large but nonspecific effect for depression treatment in PD. In addition, PD patients may benefit less from antidepressant treatment, particularly selective serotonin reuptake inhibitors, than do elderly patients without PD. © 2005 Movement Disorder Society

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