Severity of depression and anxiety are predictors of response to antidepressant
treatment in Parkinson's disease.
Author(s): Moonen AJ(1), Wijers A(2), Leentjens AF(2), Christine CW(3), Factor SA(4), Juncos
J(4), Lyness JM(5), Marsh L(6), Panisset M(7), Pfeiffer R(8), Rottenberg D(9),
Serrano Ramos C(10), Shulman L(11), Singer C(12), Slevin J(13), McDonald W(14),
Auinger P(5), Richard IH(5).
Affiliation(s): Author information:
(1)Department of Psychiatry, Maastricht University, Maastricht, The Netherlands.
Electronic address: anja.moonen@maastrichtuniversity.nl. (2)Department of
Psychiatry, Maastricht University, Maastricht, The Netherlands. (3)Department of
Neurology, University of California, San Francisco, San Francisco, CA, USA.
(4)Department of Neurology, Emory University, Atlanta, GA, USA. (5)University of
Rochester School of Medicine and Dentistry, Rochester, NY, USA. (6)Mental Health
Care Line, Michael E. DeBakey Veterans Administration Medical Center, Houston,
USA; Department of Psychiatry, Baylor College of Medicine, Houston, USA;
Department of Neurology, Baylor College of Medicine, Houston, USA. (7)Department
of Neurology, University of Montreal, Montreal, Canada. (8)Department of
Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
(9)Department of Neurology, University of Minnesota, Minneapolis, MN, USA;
Department of Radiology, University of Minnesota, Minneapolis, MN, USA.
(10)University of Puerto Rico School of Medicine, Puerto Rico. (11)Department of
Neurology, University of Maryland School of Medicine, Baltimore, USA.
(12)Department of Neurology, Leonard M. Miller School of Medicine, University of
Miami, Miami, FL, USA. (13)Department of Neurology, University of Kentucky
College of Medicine, Lexington, KY, USA. (14)Department of Psychiatry and
Behavioral Sciences, Emory University, Atlanta, GA, USA.
Publication date & source: 2014, Parkinsonism Relat Disord. , 20(6):644-6
BACKGROUND: Antidepressants have appeared to be more effective than placebo
treatment in treating depressive syndromes in patients with Parkinson's disease
(PD).
OBJECTIVE: To identify factors that predict improvement in depressive symptoms
during antidepressant treatment in depressed PD patients.
METHODS: A secondary analysis was performed on the dataset of the Randomized
Placebo-controlled Study of Antidepressants in PD (SAD-PD), in which 76 patients
received active treatment with either paroxetine or venlafaxine extended release
(XR), and 39 patients received placebo treatment. Backward stepwise regression
analyses were conducted with change in 24-item Hamilton Depression Rating Scale
(HAMD-24) score between assessments at baseline and week 12 as the main outcome
measure, and sex, age, baseline HAMD-24 score, Unified Parkinson's Disease Rating
Scale section III (UPDRS-III) score, Mini-Mental State Examination (MMSE), and
the Clinical Anxiety Scale (CAS) as independent variables.
RESULTS: In both the active treatment and placebo groups, higher baseline HAMD-24
score and lower UPDRS-III score were associated with greater reduction in HAMD-24
score. Higher anxiety scores predicted less response in the active treatment
group. Higher MMSE scores predicted greater response only in the placebo-treated
group. Sex and age were no predictors of response.
CONCLUSIONS: Higher pre-treatment depression scores and lower pre-treatment
anxiety scores are the two most important predictors for improvement during
antidepressant treatment in depressed PD patients, which is in line with those
found in treatment studies of depressed non-PD patients. Furthermore, our results
indicate the requirement for different or more intensive treatment for depressed
PD patients with more severe anxiety symptoms.
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