Journal
NEUROLOGY
Volume 78, Issue 16, Pages 1229-1236Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e3182516244
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Categories
Funding
- NIH/NINDS [R01 NS046487]
- General Clinical Research Center at Johns Hopkins University School of Medicine (National Center for Research Resources/NIH) [M01-RR00052]
- Neurologix, Inc.
- Eli Lilly and Company
- NIH/NINDS
- Cornell University
- Michael J. Fox Foundation
- Forest Laboratories, Inc.
- Medivation, Inc.
- NeuroSearch
- Boehringer Ingelheim
- Pfizer Inc
- Endo Pharmaceuticals
- NIH
- CDC
- FDA
- Spinal Muscular Atrophy Foundation
- Muscular Dystrophy Association
- American Dental Association
- Kyowa Hakko Kirin Pharma, Inc.
- Teva Pharmaceutical Industries Ltd.
- Ipsen
- Merck Serono
- Ceregene
- NIMH
- NIA
- NINDS
- NHLBI
- NICHD
- American Psychiatric Association
- Baylor College of Medicine
- Medical Communications Media
- Health Professions Conferencing
- Merz Pharmaceuticals
- LLC
- US World Meds
- Abbott
- ACADIA Pharmaceuticals
- Biotie Therapeutics
- EMD Serono, Inc.
- Novartis
- Huntington Study Group
- Movement Disorders Society
- Parkinson Study Group
- National Parkinson Foundation
- Society of Progressive Supranuclear Palsy
- Synosia Therapeutics
- NIDDK
- NCRR
- Tourette Syndrome Association
- McDonnell Center for Systems Neuroscience at Washington University
- Medtronic, Inc.
- Allon Therapeutics, Inc.
- Genzyme Corporation
- Eisai Inc.
- Schwartz Biomedical
- UCB/SCHWARZ PHARMA
- Santhera Pharmaceuticals
- Molecular Biometrics
- Columbia University
- Weill Cornell Medical College
- Northwestern University
- Indiana University
- Solvay Pharmaceuticals, Inc.
- GlaxoSmithKline
- Milton Fund
- Harvard Center for Neurodegeneration and Repair
- NIH/NIMH
- Wyeth
- Janssen
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Objective: 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). Methods: 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. Results: 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. Conclusions: 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. Classification of Evidence: This study provides Class I evidence that paroxetine and venlafaxine XR are effective in treating depression in patients with PD. Neurology (R) 2012;78:1229-1236
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