A meta-analysis of randomized placebo-controlled treatment trials for depression and anxiety in Parkinson’s disease

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 inclu...

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Main Authors: Troeung, L., Egan, Sarah, Gasson, Natalie
Format: Journal Article
Published: Public Library of Science 2013
Online Access:http://hdl.handle.net/20.500.11937/2764
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author Troeung, L.
Egan, Sarah
Gasson, Natalie
author_facet Troeung, L.
Egan, Sarah
Gasson, Natalie
author_sort Troeung, L.
building Curtin Institutional Repository
collection Online Access
description 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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spelling curtin-20.500.11937-27642017-09-13T14:45:10Z A meta-analysis of randomized placebo-controlled treatment trials for depression and anxiety in Parkinson’s disease Troeung, L. Egan, Sarah Gasson, Natalie 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. 2013 Journal Article http://hdl.handle.net/20.500.11937/2764 10.1371/journal.pone.0079510 Public Library of Science fulltext
spellingShingle Troeung, L.
Egan, Sarah
Gasson, Natalie
A meta-analysis of randomized placebo-controlled treatment trials for depression and anxiety in Parkinson’s disease
title A meta-analysis of randomized placebo-controlled treatment trials for depression and anxiety in Parkinson’s disease
title_full A meta-analysis of randomized placebo-controlled treatment trials for depression and anxiety in Parkinson’s disease
title_fullStr A meta-analysis of randomized placebo-controlled treatment trials for depression and anxiety in Parkinson’s disease
title_full_unstemmed A meta-analysis of randomized placebo-controlled treatment trials for depression and anxiety in Parkinson’s disease
title_short A meta-analysis of randomized placebo-controlled treatment trials for depression and anxiety in Parkinson’s disease
title_sort meta-analysis of randomized placebo-controlled treatment trials for depression and anxiety in parkinson’s disease
url http://hdl.handle.net/20.500.11937/2764