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Neurol Sci (2008) 29:391395 DOI 10.1007/s10072-008-1021-3
O R I G I N A L A R T I C L E
Sertraline in the treatment of depressive disorders in patients with Parkinsons disease
Silvia Marino Edoardo Sessa Giuseppe Di Lorenzo Giuseppina Digangi Antonella Alagna Placido Bramanti Paolo Di Bella
Received: 18 February 2008 / Accepted in revised form: 16 September 2008 / Published online: 11 November 2008 Springer-Verlag 2008
Abstract We studied 54 idiopathic Parkinsons disease (PD) patients with depressive disorders (DD) to compare the efficacy and the effect of treatment with sertraline in the usual formulation and in the liquid oral concentrate (LOC) formulation. After 6 months of sertraline treatment, the Hamilton Depression Rating Scale and the Montgomery and Asberg Depression Rating Scale showed a decrement (p<0.001, for both formulations). Parkinsons Disease Questionnaire scores improved (p<0.005 for usual formulation and p<0.001 for LOC formulation), as did Clinical Global Impression-Severity of Illness scale and Clinical Global Impression-Global Improvement scale scores (p=0.1, for both formulations). Mini Mental State Examination and Unified Parkinsons Disease Rating Scale motor subscores did not change. These results suggest that sertraline LOC may also be a useful treatment for DD in PD patients, especially for those with swallowing problems, and have significant benefit for quality of life, without worsening of parkinsonian features.
Keywords Parkinsons disease Sertraline Depressive disorders Quality of life
Introduction
Depression is the most common psychiatric disturbance in Parkinsons disease (PD), affecting 40% of patients [1], and its identification and treatment are critically important in disease management [2, 3]. Recognition of the signs and symptoms of depression associated with PD is essential for clinical practitioners. PD patients can appear withdrawn from social activities, because they are unable to participate due to disabling dyskinesias and are socially uncomfortable with their appearance. Treatment of depression in this subset of patients can have a direct and dramatic impact on functional disability and quality of life [4]. Practitioners should be aware of these signs and symptoms when diagnosing and treating depression associated with PD and should also be aware of the pros and cons of each treatment option and should choose a therapy appropriate for each individual patients needs [57].
Research on depression in PD has suggested that PD patients experience a qualitatively different...