A recent study compared the effects of different antidepressant therapies on depression in patients with Parkinsons disease (PD) and provided a reference for clinical treatment.

It recruited 328 patients with idiopathic PD consecutively, who met the Diagnostic and Statistical Manual of Mental Disease, Fourth Edition, criteria for a depressive disorder, or operationally defined subsyndromal depression, and scored greater than 17 on the 17-item Hamilton Depression Scale (HAMD-17).  

131 patients with PD accompanied by depression were enrolled in the experimental group and randomized into 4 groups. A total of 118 participants eventually completed the study: routine treatment group (n = 29), routine treatment + escitalopram group (n = 29), routine treatment + pramipexole group (n = 31), and routine treatment + transcranial magnetic stimulation (TMS) group (n = 29). The efficacy of each treatment was evaluated using the HAMD score and reduction rate after 4 weeks of treatments.

After 4 weeks of treatment, the HAMD score was compared between the 4 groups. Escitalopram, pramipexole, and repetitive TMS showed superior therapeutic efficiency to routine anti-PD treatment, with a statistically significant difference. No statistical difference was found between escitalopram and pramipexole, however, they were superior to rTMS. Further logistic regression analysis showed that a 50% reduction in HAMD score from baseline was associated with the treatment method, with escitalopram displaying statistical significance.

Thus, Escitalopram, pramipexole, and high-frequency TMS have better efficacy in patients with PD complicated with depression. At 4 weeks, escitalopram shows better antidepressant effects and improves patients quality of life without worsening motor function.

Clinical Neuropharmacology, 2022;45(4):84-88. doi: 10.1097/WNF.0000000000000507