Comparison of desipramine and citalopram treatments for depression in Parkinson's disease:: A double-blind, randomized, placebo-controlled study
Comparison of desipramine and citalopram treatments for depression in Parkinson's disease:: A double-blind, randomized, placebo-controlled study
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DOI：
10.1002/mds.21966
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发表时间：
2008-04-30
影响因子：
8.6
通讯作者：
Defebvre, Luc
中科院分区：
文献类型：
--
作者：
Devos, David;Dujardin, Kathy;Defebvre, Luc
抑郁症是帕金森病 (PD) 最常见的精神障碍之一。最近的评论强调了缺乏对照试验以及随之而来的在制定 PD 抗抑郁药物使用建议方面的困难。我们试图确定抗抑郁药是否能提供真正的益处，以及三环类和选择性血清素再摄取抑制剂（SSRI）抗抑郁药的短期疗效是否存在差异，因为起效时间仍然是抑郁症的一个重要标准。一项双盲、随机、安慰剂对照研究对 48 名患有重性抑郁症的非痴呆 PD 患者进行了评估，评估了两种抗抑郁药（地昔帕明，一种主要去甲肾上腺素能再摄取抑制剂三环类药物和西酞普兰，一种 SSRI）的短期疗效（14 天和 30 天后）。 14 天后，与西酞普兰和安慰剂相比，地昔帕明促使蒙哥马利阿斯伯格抑郁量表 (MADRS) 评分有所改善。 30 天后，两种抗抑郁药的 MADRS 评分均显着改善。地昔帕明组发生轻度不良事件的频率是其他组的两倍。与 SSRI 相比，以去甲肾上腺素能为主的三环类抗抑郁药对帕金森抑郁症具有更强烈的短期作用。然而，地昔帕明较低的耐受性可能超过其轻微的短期临床优势。 (c) 2008 年运动障碍协会。
Depression is one of the most common psychiatric disturbances in Parkinson's disease (PD). Recent reviews have highlighted the lack of controlled trials and the ensuing difficulty in formulating recommendations for antidepressant use in PD. We sought to establish whether antidepressants provide real benefits and whether tricyclic and selective serotonin reuptake inhibitor (SSRI) antidepressants differ in their short-term efficacy, because the time to onset of therapeutic benefit remains an important criterion in depression. The short-term efficacy (after 14 and 30 days) of two antidepressants (desipramine, a predominantly noradrenergic reuptake inhibitor tricyclic and citalopram, a SSRI) was assessed in a double-blind, randomized, placebo-controlled study of 48 nondemented PD patients suffering from major depression. After 14 days, desipramine prompted an improvement in the Montgomery Asberg Depression Rating Scale (MADRS) score, compared with citalopram and placebo. Both antidepressants produced significant improvements in the MADRS score after 30 days. Mild adverse events were twice as frequent in the desipramine group as in the other groups. A predominantly noradrenergic tricyclic antidepressant induced a more intense short-term effect on parkinsonian depression than did an SSRI. However, desipramine's lower tolerability may outweigh its slight short-term clinical advantage. (c) 2008 Movement Disorder Society.