Comparing the effects of different antidepressant therapies on depression symptoms in patients with Parkinson’s disease.

This study compared the effectiveness of different antidepressant therapies on depression in patients with Parkinson’s disease (PD). The data showed that escitalopram (Cipralex), pramipexole (Mirapex), and repetitive transcranial magnetic stimulation (rTMS) were more effective than routine treatment in these patients. After 4 weeks, escitalopram showed better antidepressant effects and improved patients' quality of life and did not worsen motor function.

Parkinson's disease (PD) is a disorder in which part of the brain is progressively damaged over many years. The main cause is the loss of nerve cells in a part of the brain called "substantia nigra". This leads to a reduction in a molecule involved in the body's movement (called dopamine). Therefore, common PD symptoms include involuntarily shaking of particular parts of the body (tremor), slow movements, and stiff and inflexible muscles. The standard treatment for this disorder is levodopa.

Around 30-50% of patients with PD have symptoms of depression and/or anxiety. Treatment options for patients with PD suffering from depression are limited. 

rTMS is a form of brain stimulation used to treat depression and anxiety. The therapy involves delivering magnetic pulses to a brain region and activating them. Pramipexole mimics dopamine in the brain and can help boost the brain’s low dopamine supply. Escitalopram is used to treat depression and anxiety. It works by helping to restore the balance of a certain natural substance (serotonin) in the brain. However, the effectiveness of different antidepressant therapies for the treatment of depression in patients with PD is still unknown.

This study involved 118 patients with PD and suffering from depression. Patients were randomly divided into 4 groups. Group 1 included 29 patients who received routine treatment (levodopa) alone. Group 2 included 29 patients who received routine treatment plus escitalopram. Group 3 included 31 patients who received routine treatment plus pramipexole. Group 4 included 29 patients who received routine treatment plus rTMS. The patients were followed up 4 weeks after treatment. A standardized questionnaire was used to measure depression.

Escitalopram, pramipexole, and rTMS were significantly more effective than routine treatment. There was no statistical difference between the effectiveness of escitalopram and pramipexole, but both were more effective than rTMS.

After 4 weeks, escitalopram showed better antidepressant effects and improved patients' quality of life and did not worsen motor function.

This study concluded that escitalopram, pramipexole, and rTMS were more effective than routine treatment in patients with PD suffering from depression. After 4 weeks, escitalopram showed better antidepressant effects and improved patients' quality of life and did not worsen motor function.

The sample size was very small. The study lasted only 4 weeks and the conclusions may not reflect the long-term treatment effect. Patients knew which treatment they were getting, and the study lacked a placebo.