SAD-PD

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心机构，不一定为研究者机构。抑郁症在帕金森病（PD）患者中很常见，是影响生活质量的主要因素。迄今为止，还没有设计良好的抗抑郁药物治疗PD抑郁症的临床试验。选择性5-羟色胺再摄取抑制剂（SSRI）和最近的联合5-羟色胺和去甲肾上腺素再摄取抑制剂（SNRI）抗抑郁药被用作抑郁症的一线治疗。然而，它们在PD中的疗效和耐受性尚未确定，并且有几个重要原因导致在原发性精神病人群中的研究结果不能简单地外推至PD患者。在PD中，潜在的病理生理学和某种非典型抑郁特征可能导致不同的抗抑郁反应。此外，PD患者特别容易受到抗抑郁药诱导的锥体外系副作用和许多可能影响这些药物一般耐受性的因素（包括伴随的抗帕金森病药物）的影响。 拟议的临床试验旨在评估帕罗西汀（SSRI）和文拉法辛缓释剂（SNRI）在PD抑郁症患者中的疗效和耐受性。还将获得关于这些药物对运动功能、生活质量和认知的影响的信息。16家临床试验机构将入组228例受试者，每例受试者将参加为期12周的试验。 该试验将澄清许多关于PD患者抑郁治疗的重要问题。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Depression is common in patients with Parkinson's disease (PD) and is a major factor negatively impacting quality of life. To date there have been no well-designed clinical trials of antidepressant pharmacotherapy for depression in PD. Selective serotonin reuptake inhibitor (SSRI) and, more recently, combined serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants are used as first-line treatment for depression. However, their efficacy and tolerability in PD have not been established and there are several important reasons why results from studies in primary psychiatric populations cannot simply be extrapolated to patients with PD. In PD, the underlying pathophysiology and somewhat atypical depressive features may result in a different antidepressant response. Furthermore, PD patients are particularly vulnerable to antidepressant-induced extrapyramidal side effects and a host of factors (including concomitant antiparkinsonian medications) that may affect the general tolerability of these agents. The proposed clinical trial has been designed to evaluate the efficacy and tolerability of paroxetine (an SSRI) and venlafaxine extended release (an SNRI) in PD patients with depression. Information regarding the effects of these medications on motor function, quality of life and cognition will also be obtained. Two hundred twenty-eight subjects will be enrolled among 16 centers and each subject will participate in the trial for 12 weeks. The trial will clarify many important questions regarding the treatment of depression in patients with PD.