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Efficacy and acceptability of selective serotonin reuptake inhibitors for the treatment of depression in Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials.

Skapinakis P, Bakola E, Salanti G, Lewis G, Kyritsis AP, Mavreas V - BMC Neurol (2010)

Bottom Line: In the comparison between SSRIs and Tricyclic Antidepressants (TCAs) (n = 3 studies) the combined risk ratio was 0.75 (0.39 - 1.42, p = 0.37).An acceptability analysis showed that SSRIs were generally well tolerated.Due to the limited number of studies and the small sample sizes a type II error (false negative) cannot be excluded.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychiatry, University of Ioannina School of Medicine, Ioannina 45110, Greece. p.skapinakis@gmail.com

ABSTRACT

Background: Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants for the treatment of depression in patients with Parkinson's Disease (PD) but data on their efficacy are controversial.

Methods: We conducted a systematic review and meta-analysis of randomized controlled trials to investigate the efficacy and acceptability of SSRIs in the treatment of depression in PD.

Results: Ten studies were included. In the comparison between SSRIs and Placebo (n = 6 studies), the combined risk ratio (random effects) was 1.08 (95% confidence interval: 0.77 - 1.55, p = 0.67). In the comparison between SSRIs and Tricyclic Antidepressants (TCAs) (n = 3 studies) the combined risk ratio was 0.75 (0.39 - 1.42, p = 0.37). An acceptability analysis showed that SSRIs were generally well tolerated.

Conclusions: These results suggest that there is insufficient evidence to reject the hypothesis of no differences in efficacy between SSRIs and placebo in the treatment of depression in PD. Due to the limited number of studies and the small sample sizes a type II error (false negative) cannot be excluded. The comparison between SSRIs and TCAs is based on only three studies and further trials with more pragmatic design are needed.

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Related in: MedlinePlus

Flow diagram of the Study.
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Figure 1: Flow diagram of the Study.

Mentions: The results of our search strategy are presented in Figure 1. A total of 412 potentially relevant articles were identified according to our search strategy and other sources (reference list of previous systematic reviews or retrieved papers). We excluded 388 papers because they were reviews, letters or irrelevant to the study aims. We retrieved the full text of 24 articles for a more detailed evaluation and 14 of them were excluded: 13 studies were uncontrolled; one study - [18] - randomized PD patients to citalopram or placebo only if they were non-depressed while the depressed participants did not have a control group (see Additional file 1 Table s1 for a list of studies excluded from the review). Finally 10 studies were included in the review.


Efficacy and acceptability of selective serotonin reuptake inhibitors for the treatment of depression in Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials.

Skapinakis P, Bakola E, Salanti G, Lewis G, Kyritsis AP, Mavreas V - BMC Neurol (2010)

Flow diagram of the Study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2903535&req=5

Figure 1: Flow diagram of the Study.
Mentions: The results of our search strategy are presented in Figure 1. A total of 412 potentially relevant articles were identified according to our search strategy and other sources (reference list of previous systematic reviews or retrieved papers). We excluded 388 papers because they were reviews, letters or irrelevant to the study aims. We retrieved the full text of 24 articles for a more detailed evaluation and 14 of them were excluded: 13 studies were uncontrolled; one study - [18] - randomized PD patients to citalopram or placebo only if they were non-depressed while the depressed participants did not have a control group (see Additional file 1 Table s1 for a list of studies excluded from the review). Finally 10 studies were included in the review.

Bottom Line: In the comparison between SSRIs and Tricyclic Antidepressants (TCAs) (n = 3 studies) the combined risk ratio was 0.75 (0.39 - 1.42, p = 0.37).An acceptability analysis showed that SSRIs were generally well tolerated.Due to the limited number of studies and the small sample sizes a type II error (false negative) cannot be excluded.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychiatry, University of Ioannina School of Medicine, Ioannina 45110, Greece. p.skapinakis@gmail.com

ABSTRACT

Background: Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants for the treatment of depression in patients with Parkinson's Disease (PD) but data on their efficacy are controversial.

Methods: We conducted a systematic review and meta-analysis of randomized controlled trials to investigate the efficacy and acceptability of SSRIs in the treatment of depression in PD.

Results: Ten studies were included. In the comparison between SSRIs and Placebo (n = 6 studies), the combined risk ratio (random effects) was 1.08 (95% confidence interval: 0.77 - 1.55, p = 0.67). In the comparison between SSRIs and Tricyclic Antidepressants (TCAs) (n = 3 studies) the combined risk ratio was 0.75 (0.39 - 1.42, p = 0.37). An acceptability analysis showed that SSRIs were generally well tolerated.

Conclusions: These results suggest that there is insufficient evidence to reject the hypothesis of no differences in efficacy between SSRIs and placebo in the treatment of depression in PD. Due to the limited number of studies and the small sample sizes a type II error (false negative) cannot be excluded. The comparison between SSRIs and TCAs is based on only three studies and further trials with more pragmatic design are needed.

Show MeSH
Related in: MedlinePlus