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TREATMENT OF DEPRESSION
IN PARKINSON’S DISEASE IN THE VERY OLD
Brian Trappler and Steven
Friedman
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OBJECTIVE: To examine the effect of selective serotonin-reuptake inhibitors in very old patients with Parkinson’s disease and major depression.
DESIGN: Nonrandomized, open-label, prospective study.
SETTING: Two skilled nursing facilities.
PATIENTS: Twelve patients, 5 with idiopathic Parkinson’s disease and 7 with secondary Parkinson’s syndrome.
INTERVENTION: Twelve-week course of fluoxetine 20 mg, sertraline 75-100 mg, or paroxetine 20 mg per day.
MAIN OUTCOME MEASURES: Depression was rated clinically by using criteria from the Diagnostic and Statistical Manual of Mental Disorders IV as well as the first 17 items of the Hamilton Depression Rating Scale. The Folstein Mini Mental Status Examination was used to diagnose dementia. A modified Hachinski Scale was used to diagnose vascular dementia.
RESULTS: The mean reduction in the Hamilton depression score for the entire group was 33%. A 50% reduction in the Hamilton depression score was achieved in two of five patients with idiopathic Parkinson’s disease and in one of seven patients with secondary Parkinson’s syndrome.
CONCLUSIONS: Response to treatment was poor in patients whose Parkinson’s disease and depression were complicated by dementia and cerebrovascular insufficiency.
J Pharm Technol 1998;14:110-15.
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