Comparative study of citalopram and amitriptyline in depression in patients with Parkinson’s disease

Background: Despite 40–50% of patients with Parkinson’s Disease (PD) suffer from depression, antidepressant comparative studies are lacking. Method: The primary objective of this open-label, randomized, prospective study was to compare antidepressive efficacy of a 6-week treatment with citalopram [C] (20mg/day, n=9) or amitriptyline [A] (150mg/day, n=6) in ambulatory depressive, non-demented PD patients. Primary efficacy measure was a 50% reduction of the HAMD-21-Score. Secondary objectives were to compare tolerability, safety, effects on anxiety, motor function, cognitive function and quality of life. Preliminary results: 3 patients discontinued medication in [C] . In both [A] or [C] a significant reduction of depressive symptoms, anxiety and improvement of quality of life was observed. There was no significant difference in response-rates. No adverse effects on motor function were recorded. Cognitive dysfunction related to depression improved during successful antidepressive treatment. Conclusion: This study confirmed the therapeutic value of citalopram or amitriptyline as antidepressants in patients with PD. Preliminary results of 15 treated patients could not show a statistical significant difference between the two treatment groups.