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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 (Price et al., 2011”
From Remote delivery of psychological interventions for Parkinson's disease. (2018) · cites this paper as Troeung et al., 2013
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2 of the 86 references couldn’t be matched to a known paper.
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Items 101–132 of 132
Mood Disorders in Parkinson's Disease
Mufti, S., & LaFaver, K. (2020) · Psychiatric Annals · doi:10.3928/00485713-20200203-01 · Cited by 2
Costello, H., Schrag, A., Howard, R., & Roiser, J. (2023) · medRxiv · doi:10.1101/2023.06.30.23292073
Costello, H., Yamamori, Y., Kieslich, K., Murphy, M., Bobyreva, K., Schrag, A. E., Howard, R. J., & Roiser, J. P. (2024) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2024.05.09.592897 · Cited by 2
“4 However, depression in PD goes undiagnosed in up to half of patients, and current treatments for depressed mood are poorly e ff ective 5–8 .”
BackgroundDepression in neurodegenerative disease: neurobiological mechanisms and emerging treatments
Costello, H., Reeves, S., Glue, P., Young, A. H., & Howard, R. J. (2026) · Molecular Psychiatry · doi:10.1038/s41380-026-03728-8 · Cited by 1
“Meta-analyses consistently demonstrate little evidence of clinical ef fi cacy of existing antidepressants in AD or PD depression [15 – 18].”
Mood Disorders in Parkinson’s Disease
Tsai, P., & Gopalakrishna, G. (2022) · Cambridge University Press eBooks · doi:10.1017/9781009039291.010 · Cited by 1
Drug Treatment of Psychiatric Symptoms Occurring in the Context of Other Disorders
(2021) · Wiley eBooks · doi:10.1002/9781119870203.mpg010 · Cited by 1
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Depressie bij de ziekte van Parkinson; de huidige stand van zaken
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Lebrun, C., Gély-Nargeot, M.-C., Cock, V. C. D., & Bayard, S. (2016) · Journal de Thérapie Comportementale et Cognitive · doi:10.1016/j.jtcc.2016.03.004
Lessons and challenges of trials for cognitive and behavioral complications of Parkinson's disease
Weintraub, D. A., & Chahine, L. M. (2016) · Cambridge University Press eBooks · doi:10.1017/cbo9781107284210.030
Clinical Trials in Parkinson's Diease: Lessons, Controversies and Challenges
(2016) · Cambridge University Press eBooks · doi:10.1017/cbo9781107284210.022
Knowledge, Attitudes and Behaviors to Dietary Management of Parkinson’s Disease
Hurley, L. (2018) · doi:10.23860/thesis-hurley-leah-2018
“0-105 was calculated and categorized with one of three nutritional risk levels; (<60) at risk, (60-75) possible risk, and (>75) not at risk(31).”
MethodMalattia di Parkinson e depressione
Laurencin, C., & Thobois, S. (2019) · EMC - Neurologia · doi:10.1016/s1634-7072(19)42021-7
Neuropsychiatric Symptoms in the Course of Parkinson’s Disease
Rothenberg, K. G. (2020) · Biomedical Journal of Scientific & Technical Research · doi:10.26717/bjstr.2020.28.004713
“CBT appears to be a particularly promising non-pharmacological approach [32] In more advanced depression pharmacotherapy is often indicated.”
BackgroundChen, J., Xu, P., Guo, X., & Zou, T. (2020) · doi:10.21203/rs.3.rs-16540/v1
“Several new antidepressant regimens have emerged in clinical practice in recent years, including cognitive therapy, electroconvulsive therapy, transcranial magnetic stimulation (TMS), and other psychological and physical therapies [16], but no therapy has a definite efficacy [11].”
BackgroundBhoopatiraju, S., & Grossberg, G. T. (2021) · touchREVIEWS in Neurology · doi:10.17925/usn.2021.17.2.97
Neuropsychiatric (Behavioral) Symptoms in Parkinson’s Disease
Rothenberg, K. G. (2022) · Cambridge University Press eBooks · doi:10.1017/9781009039291.009
Manejo dos Sintomas Não Motores na Doença de Parkinson
Júnior, P. J. D. S., Couto, K. O., de Amorim, M. C. C. S., Rocha, R. S., Ribeiro, M. L., Barberino, L., Martin, D. L. S., Branco, R. C. C., Pereira, D. F., Farias, D. S., et al. (2022) · Revista Científica Hospital Santa Izabel · doi:10.35753/rchsi.v6i1.248
Parkinson’s Disease and Atypical Parkinsonian Syndromes
Ridgeway‐Diaz, J. G., & Marsh, L. (2022) · Oxford University Press eBooks · doi:10.1093/med/9780197574317.003.0017
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The Neurology–Psychiatry Interface
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Is Telerehabilitation Effective in Parkinson's Disease?Preprint
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Carey, G. (2026) · EMC - Neurologia · doi:10.1016/s0246-0378(25)50183-5
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Metadata
- 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 › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- 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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