December 21, 2017
Certain classes of antidepressants may effectively treat depression in individuals with Parkinson disease (PD), according to a recent systematic review and meta-analysis.
For their review, the researchers identified 3191 randomized controlled trials that had investigated the efficacy of antidepressant medications compared with a non-treatment, placebo, or active treatment groups for depressive symptoms in PD. Of these studies, 20 (1893) patients were included, but not all could be meta-analyzed (Int J Geriatr Psychiatry. doi:10.1002/gps.4834).
Depression scores were compared between active drug and placebo or control groups via random-effects model meta-analysis, and the effectiveness of different antidepressant classes was compared using a network meta-analysis.
The primary outcome, which was measured by standardized mean difference (SMD) in depression score from baseline compared with control, was defined as the efficacy of different classes of antidepressant medications in PD patients with depressive symptoms.
Findings from a pairwise meta-analysis indicated that type B-selective monoamine oxidase inhibitors (SMD = -1.28), selective serotonin reuptake inhibitors (SMD = -0.49), and tricyclics (SMD = -0.83) are effective treatments for depressive symptoms in patients with PD.
In particular, the network meta-analysis suggested that monoamine oxidase inhibitors have the largest effect on depression in PD (SMD = -0.78) compared with selective serotonin reuptake inhibitors. However, these might not be viewed as traditional antidepressants due to their type B selectivity.
“Although limited by few data, this review suggests that multiple antidepressant classes are potentially efficacious in the treatment of depression in PD, but that further comparative efficacy and tolerability research is needed,” the researchers concluded.