A randomized, double-blind, placebo-controlled trial of antidepressants in Parkinson disease.


Journal Article

To evaluate the efficacy and safety of a selective serotonin reuptake inhibitor (SSRI) and a serotonin and norepinephrine reuptake inhibitor (SNRI) in the treatment of depression in Parkinson disease (PD).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.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.Both paroxetine and venlafaxine XR significantly improved depression in subjects with PD. Both medications were generally safe and well tolerated and did not worsen motor function.This study provides Class I evidence that paroxetine and venlafaxine XR are effective in treating depression in patients with PD.

Full Text

Duke Authors

Cited Authors

  • Richard, IH; McDermott, MP; Kurlan, R; Lyness, JM; Como, PG; Pearson, N; Factor, SA; Juncos, J; Serrano Ramos, C; Brodsky, M; Manning, C; Marsh, L; Shulman, L; Fernandez, HH; Black, KJ; Panisset, M; Christine, CW; Jiang, W; Singer, C; Horn, S; Pfeiffer, R; Rottenberg, D; Slevin, J; Elmer, L; Press, D; Hyson, HC; McDonald, W; SAD-PD Study Group,

Published Date

  • April 11, 2012

Published In

Volume / Issue

  • 78 / 16

Start / End Page

  • 1229 - 1236

PubMed ID

  • 22496199

Pubmed Central ID

  • 22496199

Electronic International Standard Serial Number (EISSN)

  • 1526-632X

International Standard Serial Number (ISSN)

  • 0028-3878

Digital Object Identifier (DOI)

  • 10.1212/WNL.0b013e3182516244


  • eng