A meta-analysis of randomised placebo-controlled treatment trials for depression and anxiety in Parkinson's disease
Open accessAbstract
BACKGROUND: Psychopharmacotherapy currently constitutes the first-line treatment for depression and anxiety in Parkinson's disease (PD) however the efficacy of antidepressant treatments in PD is unclear. Several alternative treatments have been suggested as potentially more viable alternatives including dopamine agonists, repetitive transcranial magnetic stimulation, and cognitive behavioural therapy (CBT). METHOD: A meta-analysis of randomised placebo-controlled trials for depression and/or anxiety in PD was conducted to systematically examine the efficacy of current treatments for depression and anxiety in PD. RESULTS: Nine trials were included. There was only sufficient data to calculate a pooled effect for antidepressant therapies. The pooled effect of antidepressants for depression in PD was moderate but non-significant (d = .71, 95% CI = -1.33 to 3.08). The secondary effect of antidepressants on anxiety in PD was large but also non-significant (d = 1.13, 95% CI = -.67 to 2.94). Two single-trials of non-pharmacological treatments for depression in PD resulted in significant large effects; Omega-3 supplementation (d = .92, 95% CI = .15 to 1.69) and CBT (d = 1.57, 95% CI = 1.06 to 2.07), and warrant further exploration. CONCLUSIONS: There remains a lack of controlled trials for both pharmacological and non-pharmacological treatments for depression and anxiety in PD which limits the conclusions which can be drawn. While the pooled effects of antidepressant therapies in PD were non-significant, the moderate to large magnitude of each pooled effect is promising. Non-pharmacological approaches show potential for depression in PD however more research is required.
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Evidence for the effectiveness of pharmacological interventions in treating PD neuropsychiatric symptoms is mixed.
“Evidence for the effectiveness of pharmacological interventions in treating PD neuropsychiatric symptoms is mixed (Price et al., 2011”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Troeung et al., 2013
The Introduction says the efficacy of antidepressants in Parkinson’s disease remains unclear, and the Results report non-significant pooled effects despite promising effect sizes. This supports describing the evidence as mixed for depression and anxiety, but the paper does not establish that conclusion for Parkinson’s disease neuropsychiatric symptoms more broadly. (LLM, conf=0.85)
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- Authors
- Troeung, L., Egan, S. J., & Gasson, N.
- Affiliations
- Curtin University (AU)
- Corresponding author
- Troeung, Lakkhina
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-11-13
- Volume
- 8
- Issue
- 11
- Pages
- e79510
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3827386
- OpenAlex
- W2022947342
- Cited by
- 132
- References
- 86
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 7 · 2023: 7 · 2022: 16 · 2021: 10 · 2020: 6 · 2019: 14 · 2018: 7 · 2017: 7 · 2016: 20 · 2015: 10 · 2014: 11
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- eSpace (Curtin University) (submittedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Keywords
- Parkinson's disease, depression, anxiety, antidepressants, psychopharmacological treatment, dopamine agonists, repetitive transcranial magnetic stimulation, cognitive behavioral therapy, omega-3 supplementation, non-pharmacological treatment, treatment efficacy
- MeSH terms
- Antidepressive Agents, Anxiety, Depression, Humans, Parkinson Disease, Psychotherapy, Randomized Controlled Trials as Topic, Treatment Outcome
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