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Comparative study of citalopram and amitriptyline in depression in patients with Parkinson’s disease
Background: Despite 40–50% of patients with Parkinson’s Disease (PD) suffer from depression, antidepressant comparative studies are lacking.
Method: The primary objective of this open-label, randomized, prospective study was to compare antidepressive efficacy of a 6-week treatment with citalopram [C] (20mg/day, n=9) or amitriptyline [A] (150mg/day, n=6) in ambulatory depressive, non-demented PD patients. Primary efficacy measure was a 50% reduction of the HAMD-21-Score. Secondary objectives were to compare tolerability, safety, effects on anxiety, motor function, cognitive function and quality of life.
Preliminary results: 3 patients discontinued medication in [C]. In both [A] or [C] a significant reduction of depressive symptoms, anxiety and improvement of quality of life was observed. There was no significant difference in response-rates. No adverse effects on motor function were recorded. Cognitive dysfunction related to depression improved during successful antidepressive treatment.
Conclusion: This study confirmed the therapeutic value of citalopram or amitriptyline as antidepressants in patients with PD. Preliminary results of 15 treated patients could not show a statistical significant difference between the two treatment groups.