Depression in Parkinson's disease and the safety of using paroxetine

S. Ruggieri, M. F. De Pandis, M. Torti, U. Bonuccelli, M. Onofrj, A. Bonamartini, F. Stocchi

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Depression is considered to be the most common psychiatric manifestation in Parkinson's disease (PD) patients. According to most studies it occurs in approximately 40% of patients with PD; half of these patients meet the criteria for major depressive episodes (MD), half of them have dysthymia or minor depression. To date the aetiology of depression in PD still remains unclear: it has been explained either as a reaction to the functional impairment or as a symptom of an underlying organic deficit. Several studies failed to demonstrate a correlation between depression and the degree of PD-related functional deficit. However, patients who experienced ON-OFF phenomenon complain of a greater level of depression during the OFF state, suggesting a role for dopamine in mood regulation. Different authors reported a low level of serotonin in the brain of patients suffering from PD. It has been shown that despite the levodopa treatment depression is still present in a large percentage of patients. Anecdotal reports described cases of parkinsonism in patients treated with SSRI drugs. On the other hand these compounds are very effective in the treatment of depression. In this study the efficacy and safety of the SSRI compound paroxetine has been tested. Sixty patients suffering from PD and depression were asked to participate in the study. The patients were accurately tested for their motor symptoms (UPDRS scale, ONOFF chart) and depressive symptoms (Beck's depression inventory and PDQ 39) at baseline and at week, 12, 24, 52. Paroxetine was given at the dosage of 20-40 mg/day and the other antiparkinsonian drugs were kept unchanged. Paroxetine induced a significant improvement of depression in most of the patients. The drug was well tolerated and there was not a worsening of parkinsonism. (These data are at interim as the study is still on-going.).

Original languageEnglish
Pages (from-to)278
Number of pages1
JournalItalian Journal of Neurological Sciences
Issue number4
Publication statusPublished - 1999

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology


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