A controlled trial of antidepressants in patients with Parkinson disease and depression
Why is this work in the frame?
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
No Canadian affiliation. An affiliation-only frame — the usual design — would never have seen this work. It is one of the works that make the case for inverting the frame.
Machine scores (provisional)
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
- Teacher spread
- 0.226 · how far apart the two teachers sit on this one work
- Validation status
score_only:v0-immature-baseline· verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it
Abstract
<b>Background:</b> Parkinson disease (PD) is a common neurodegenerative disease affecting up to 1 million individuals in the United States. Depression affects up to 50% of these patients and is associated with a variety of poor outcomes for patients and their families. Despite this, there are few evidence-based data to guide clinical care. <b>Methods:</b> An NIH-funded, randomized, controlled trial of paroxetine CR, nortriptyline, and placebo in 52 patients with PD and depression. The primary outcomes were the change in the Hamilton Depression Rating Scale (HAM-D) and the percentage of depression responders at 8 weeks. <b>Results:</b> Nortriptyline was superior to placebo for the change in HAM-D (<i>p</i> < 0.002); paroxetine CR was not. There was a trend for superiority of nortriptyline over paroxetine CR at 8 weeks (<i>p</i> < 0.079). Response rates favored nortriptyline (<i>p</i> = 0.024): nortriptyline 53%, paroxetine CR 11%, placebo 24%. In planned contrasts of response rates, nortriptyline was superior to paroxetine CR (<i>p</i> = 0.034). Nortriptyline was also superior to placebo in many of the secondary outcomes, including sleep, anxiety, and social functioning, while paroxetine CR was not. Both active drug treatments were well tolerated. <b>Conclusions:</b> Though relatively modest in size, this is the largest placebo-controlled trial done to date in patients with Parkinson disease (PD) and depression. Nortriptyline was efficacious in the treatment of depression and paroxetine CR was not. When compared directly, nortriptyline produced significantly more responders than did paroxetine CR. The trial suggests that depression in patients with PD is responsive to treatment and raises questions about the relative efficacy of dual reuptake inhibitors and selective serotonin reuptake inhibitors. <b>ARR</b> = absolute risk reduction; <b><i>DSM-IV</i></b> = <i>Diagnostic and Statistical Manual of Mental Disorders,</i> 4th edition; <b>HAM-A</b> = Hamilton Anxiety Scale; <b>HAM-D</b> = Hamilton Depression Rating Scale; <b>MMSE</b> = Mini-Mental State Examination; <b>NNT</b> = number needed to treat; <b>PD</b> = Parkinson disease; <b>PDQ</b> = Parkinson’s Disease Questionnaire; <b>PSQI</b> = Pittsburgh Sleep Quality Index; <b>SCID</b> = Structured Clinical Interview; <b>SSRI</b> = selective serotonin reuptake inhibitor; <b>TCA</b> = tricyclic antidepressant; <b>UPDRS</b> = Unified Parkinson’s Disease Rating Scale.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
The record
- Venue
- Neurology
- Topic
- Parkinson's Disease Mechanisms and Treatments
- Field
- Medicine
- Canadian institutions
- —
- Funders
- National Institutes of HealthNational Institute of Neurological Disorders and StrokeNational Institute of Mental HealthValeant Pharmaceuticals InternationalSanofiGlaxoSmithKlinePfizerNational Institute on Alcohol Abuse and AlcoholismAllerganEli Lilly and CompanyBristol-Myers Squibb
- Keywords
- NortriptylineParoxetinePlaceboDepression (economics)Internal medicineMedicinePsychiatryPsychologyAnxietyAntidepressantAmitriptylineAlternative medicine
- Has abstract in OpenAlex
- yes