SAD-PD

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 抑郁症在帕金森氏病患者中很常见，是影响生活质量的主要因素。到目前为止，还没有设计良好的抗抑郁药物治疗帕金森病患者的临床试验。选择性5-羟色胺再摄取抑制剂(SSRI)和最近联合使用的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药物。然而，它们在帕金森病中的疗效和耐受性还没有确定，有几个重要的原因使得在初级精神病学人群中的研究结果不能简单地推论到帕金森病患者。在帕金森病中，潜在的病理生理和某种程度上的非典型抑郁特征可能会导致不同的抗抑郁反应。此外，帕金森病患者特别容易受到抗抑郁剂引起的锥体外系副作用以及可能影响这些药物一般耐受性的一系列因素(包括伴随的抗帕金森药物)的影响。 这项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)对帕罗西汀抑郁患者的疗效和耐受性。关于这些药物对运动功能、生活质量和认知的影响的信息也将被获得。将在16个中心招募228名受试者，每个受试者将参加为期12周的试验。 这项试验将澄清许多有关帕金森病患者抑郁症治疗的重要问题。

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.