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This randomized, double-blind, placebo-controlled trial addressed two important questions: whether depression in Parkinson disease (PD) responds to “standard” antidepressants and whether the choice of drug makes a difference. Patients with dementia or who had failed more than one antidepressant trial were excluded. The 52 participants (mean age, 62; mean Hoehn-Yahr score, 2.2) began with 12.5 mg of paroxetine CR, titrated as needed to 37.5 mg daily; 25 mg of nortriptyline, titrated to 75 mg daily; or matched placebo. The authors assessed the primary outcome, change in Hamilton Rating Scale for Depression (HAM-D) score, at 2, 4, and 8 weeks.
Nortriptyline recipients, but not paroxetine recipients, had a significantly greater improvement in me…