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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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“Several alternate treatments have been suggested as safer and potentially more effective alternatives than antidepressant therapies and include dopamine agonists [28–34], Omega-3 fatty-acid supplementation [35–37], repetitive transcranial magnetic stimulation (rTMS) [38–43], and cognitive behavioural therapy (CBT) [44…”
BackgroundA controlled trial of antidepressants in patients with Parkinson’s disease and depression
Morgan, J. C., & Sethi, K. D. (2009) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-009-0038-1 · Cited by 21
Drug treatment of non-motor symptoms in Parkinson’s disease
Müller, T. H. (2002) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.3.4.381 · Cited by 20 · cited 1×
“PD are complicated by concerns regarding polypharmacy [25,26] and safety [27].”
BackgroundMarino, L. J., & Friedman, J. H. (2012) · International Journal of Neuroscience · doi:10.3109/00207454.2012.726300 · Cited by 19 · cited 1×
“There have been several uncontrolled trials [7–13] and randomised controlled trials (RCT) [14–23] of antidepressants in PD to date, however, the efficacy of antidepressant treatments in PD remains unclear.”
BackgroundKormos, T. C. (2007) · Movement Disorders · doi:10.1002/mds.21613 · Cited by 13 · cited 1×
“Several alternate treatments have been suggested as safer and potentially more effective alternatives than antidepressant therapies and include dopamine agonists [28–34], Omega-3 fatty-acid supplementation [35–37], repetitive transcranial magnetic stimulation (rTMS) [38–43], and cognitive behavioural therapy (CBT) [44…”
BackgroundRepetitive transcranial magnetic stimulation as treatment for depression in Parkinson's disease
Chen, R. E. (2010) · Movement Disorders · doi:10.1002/mds.23266 · Cited by 12 · cited 1×
“Several alternate treatments have been suggested as safer and potentially more effective alternatives than antidepressant therapies and include dopamine agonists [28–34], Omega-3 fatty-acid supplementation [35–37], repetitive transcranial magnetic stimulation (rTMS) [38–43], and cognitive behavioural therapy (CBT) [44…”
BackgroundP01-29 - Depression in Parkinson's Disease- Searching for the most Potent Antidepressant
Djokic, G., Zivkovic, N., Pavicevic, D., & Lazic, D. (2010) · European Psychiatry · doi:10.1016/s0924-9338(10)70248-0 · Cited by 5
A New (Old) Treatment Option for Depression in Parkinson's Disease
BLACK, K. J. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.11071124 · Cited by 5 · cited 2×
“In recognition of the potential of CBT for depression in PD, Black [79] recently urged researchers and clinicians alike to truly consider the utility of this ‘new (old)’ treatment modality as an alternate to current pharmacological regimens for depression in PD. Limitations and Direction for Future Research There are…”
BackgroundCognitive behaviour therapy for depression in Parkinson’s disease
Laidlaw, K. (2008) · Oxford University Press eBooks · doi:10.1093/med:psych/9780198569459.003.0016 · Cited by 3 · cited 1×
“Several alternate treatments have been suggested as safer and potentially more effective alternatives than antidepressant therapies and include dopamine agonists [28–34], Omega-3 fatty-acid supplementation [35–37], repetitive transcranial magnetic stimulation (rTMS) [38–43], and cognitive behavioural therapy (CBT) [44…”
Background
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Cited by
Sorted by citations
Pharmacological Treatment of Parkinson Disease
Connolly, B. S., & Lang, A. E. (2014) · JAMA · doi:10.1001/jama.2014.3654 · Cited by 1,510
Depression in neurodegenerative diseases: Common mechanisms and current treatment options
Galts, C., Bettio, L. E. B., Jewett, D. C., Yang, C. C., Brocardo, P. S., Rodrigues, A. L. S., Thacker, J. S., & Gil‐Mohapel, J. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.04.002 · Cited by 276
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Neuroimaging of Parkinson's disease: Expanding views
Weingarten, C. P., Sundman, M. H., Hickey, P., & Chen, N. (2015) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2015.09.007 · Cited by 164
Antidepressive treatments for Parkinson's disease: A systematic review and meta-analysis
Bomasang-Layno, E., Fadlon, I., Murray, A. N., & Himelhoch, S. S. (2015) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2015.04.018 · Cited by 142
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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