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Antidepressants work for Parkinsonís disease patients

Saturday April 14, 2012
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Certain antidepressants appear to decrease depression in people with Parkinsonís disease without worsening motor problems, according to a study.

"These results are exciting because depression is common in Parkinsonís, but we werenít sure about the best way to treat it," Irene H. Richard, MD, of the University of Rochester Medical Center and author of the study, said in a news release.

"Older antidepressants are effective but have a lot of side effects. The newer antidepressants have fewer side effects, but we didnít know if theyíd be effective in people with Parkinsonís. We were also worried that they might worsen the motor problems that come with the disease," added Richard, a member of the American Academy of Neurology.

In addition to physical problems, Parkinsonís can also cause psychological symptoms, the researchers noted. Almost half of people with Parkinsonís suffer from depression, and the disorder is a major cause of disability.

The drugs tested were paroxetine, a selective serotonin reuptake inhibitor, and venlafaxine extended release, a serotonin and norepinephrine reuptake inhibitor.

The clinical trial lasted three months and involved 115 people in various stages of Parkinsonís disease who met the criteria for depression. About a third of the participants received paroxetine, a third received venlafaxine and a third received a placebo. The researchers were able to increase dosages until the participantís depression was effectively treated.

On average, the people receiving paroxetine had a 13-point (59%) improvement and those receiving venlafaxine had an 11-point (52%) improvement in their scores on the Hamilton Rating Scale for Depression. People who received the placebo had a 6.8-point (32%) improvement.

"The study suggests that while there is a clear placebo effect, there is a greater benefit from the antidepressant medications," Richard said.

The drugs were generally well tolerated and did not lead to worsening in motor functioning, the researchers said.

The study appeared April 11 on the website of Neurology, the medical journal of the American Academy of Neurology. To view the data and access the study via subscription or purchase, visit http://tinyurl.com/79gf84v.

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