Comparison of desipramine and citalopram treatments for depression in Parkinson's disease: A double-blind, randomized, placebo-controlled study

Authors

  • David Devos MD, PhD,

    Corresponding author
    1. Department of Neurology, IFR114, Institute of Predictive Medicine and Therapeutic Research, Lille University Hospital, Lille, France
    • Hôpital R. Salengro, Clinique Neurologique, CHRU, F-59037 LILLE Cedex, France

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  • Kathy Dujardin PhD,

    1. Department of Neurology, IFR114, Institute of Predictive Medicine and Therapeutic Research, Lille University Hospital, Lille, France
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  • Isabelle Poirot MD,

    1. Department of Neurophysiology, IFR114, Institute of Predictive Medicine and Therapeutic Research, Lille University Hospital, Lille, France
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  • Caroline Moreau MD,

    1. Department of Neurology, IFR114, Institute of Predictive Medicine and Therapeutic Research, Lille University Hospital, Lille, France
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  • Olivier Cottencin MD,

    1. Department of Psychiatry, IFR114, Institute of Predictive Medicine and Therapeutic Research, Lille University Hospital, Lille, France
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  • Pierre Thomas MD, PhD,

    1. Department of Psychiatry, IFR114, Institute of Predictive Medicine and Therapeutic Research, Lille University Hospital, Lille, France
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  • Alain Destée MD,

    1. Department of Neurology, IFR114, Institute of Predictive Medicine and Therapeutic Research, Lille University Hospital, Lille, France
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  • Regis Bordet MD, PhD,

    1. Department of Pharmacology, IFR 114, Institute of Predictive Medicine and Therapeutic Research, Lille University Hospital, Lille, France
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  • Luc Defebvre MD, PhD

    1. Department of Neurology, IFR114, Institute of Predictive Medicine and Therapeutic Research, Lille University Hospital, Lille, France
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Abstract

Depression is one of the most common psychiatric disturbances in Parkinson's disease (PD). Recent reviews have highlighted the lack of controlled trials and the ensuing difficulty in formulating recommendations for antidepressant use in PD. We sought to establish whether antidepressants provide real benefits and whether tricyclic and selective serotonin reuptake inhibitor (SSRI) antidepressants differ in their short-term efficacy, because the time to onset of therapeutic benefit remains an important criterion in depression. The short-term efficacy (after 14 and 30 days) of two antidepressants (desipramine, a predominantly noradrenergic reuptake inhibitor tricyclic and citalopram, a SSRI) was assessed in a double-blind, randomized, placebo- controlled study of 48 nondemented PD patients suffering from major depression. After 14 days, desipramine prompted an improvement in the Montgomery Asberg Depression Rating Scale (MADRS) score, compared with citalopram and placebo. Both antidepressants produced significant improvements in the MADRS score after 30 days. Mild adverse events were twice as frequent in the desipramine group as in the other groups. A predominantly noradrenergic tricyclic antidepressant induced a more intense short-term effect on parkinsonian depression than did an SSRI. However, desipramine's lower tolerability may outweigh its slight short-term clinical advantage. © 2008 Movement Disorder Society

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