Atomoxetine for depression and other neuropsychiatric symptoms in Parkinson disease

摘要: Objectives: Depression and antidepressant use, especially selective serotonin reuptake inhibitors (SSRIs), are common in Parkinson disease (PD). The objective of this clinical trial was to assess the efficacy atomoxetine, a norepinephrine inhibitor (SNRI), for treatment clinically significant depressive symptoms comorbid neuropsychiatric PD. Methods: A total 55 subjects with PD an Inventory Depressive Symptomatology–Clinician (IDS-C) score ≥22 were randomized 8 weeks atomoxetine or placebo (target dosage = 80 mg/day). response (>50% decrease IDS-C Clinical Global Impression–Improvement [CGI-I] 1 2) assessed using intention-to-treat modeling procedures. Secondary outcomes included global cognition, daytime sleepiness, anxiety, apathy, motor function. Results: There no between-groups differences priori–defined rates. Using more liberal criterion >40% IDS from baseline, there trend ( p 0.08) favoring atomoxetine. Patients receiving experienced significantly greater improvement cognition 0.003) sleepiness 0.001), well-tolerated. Conclusions: Atomoxetine not efficacious PD, but associated cognitive performance sleepiness. Larger studies SNRIs disorders mood, wakefulness appropriate. Classification evidence: This interventional study provides Class II evidence that mg/day) is improving depression