Tricyclics remain a good choice for depressed patients with neurologic disease.
Few double-blind, placebo-controlled treatment trials exist regarding depression in patients with neurological disorders. Using a strong study design with both active and placebo controls, researchers compared outcomes after 8 weeks’ treatment with paroxetine CR, nortriptyline, and placebo in 52 cognitively intact patients with Parkinson disease and major depression (mean age, 63; 25 women).
Paroxetine was started at 12.5 mg/day (maximum dose, 37.5 mg/day; average dose, 28.4 mg/day). Nortriptyline was started at 25.0 mg/day (maximum dose, 75.0 mg/day; average dose, 48.5 mg/day). Completion rates were similar in the three groups.
At 8 weeks, nortriptyline was superior to placebo in the main outcome measure (change from baseline on a standardiz…
Reviewing Author
DisclosuresRoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions
Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience
Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)
DisclosuresRoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions
Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience
Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)