The Effects of Sertraline on Depression in Parkinson's Disease
Condition: Depression; Parkinson's Disease
MeSH terms: Parkinson Disease; Depression; Depressive Disorder
Study type: Interventional

Summary: 
      The aim of this open-label, self-control study is to evaluate the efficacy of sertraline in
      treating depression in Patients with Parkinson's disease. In addition, the investigators also
      want to find out whether patient gets better quality of life when depression is improved.
    

Detailed description: 
      Depression in PD is associated with more severe cognitive and functional impairments, a
      faster progression of illness, worse quality of life, increase mortality and higher burden
      for caregivers, when compare PD patients without depression. Depression accounts for
      approximately 40-50% in PD patients, which is also well known as a main factor impacting on
      health-related quality of life (HRQoL) in negative way in the context of PD and even their
      caregivers. In our previous cross-sectional study, the investigators have already studied the
      prevalence of depressive symptoms in PD patients and also have proved how depressive symptoms
      severely worsen HRQoL in PD patients in the area of the mainland China. In order to improve
      HRQoL of PD, some interventions, for example, taking some antidepressants to improve
      depression are urgently required. In addition, the investigators had already tested the
      validity and reliability of Chinese version of the 39-item Parkinson's disease questionnaire
      (PDQ-39) in mainland China, the paper about which already have been published in journal of
      Zhejiang university science B (biomedicine and biotechnology) already, therefore, the
      investigators can use the questionnaire of Chinese version of PDQ-39 to assess PD patients'
      quality of life.

      Treatment of depression with antidepressant drugs is well established. In the last 20 years,
      the application of antidepressant has risen mainly due to the introduction of the selective
      serotonin reuptake inhibitors (SSRIs). These drugs are now the most commonly prescribed
      antidepressants in patients with depression in general. Regarding depression in the context
      of PD, a recent survey in the U.S. showed that 63% of the prescriptions for depression in PD
      were for SSRIs and only 7.5% for tricyclic antidepressants (TCAs). The preference of SSRIs
      over the older TCAs is supposedly based on their similar efficacy but better tolerability,
      especially when compared with tertiary amines, such as amitriptyline or imipramine.
      Sertraline is characterized by a low selectivity for serotonin relative to dopamine reuptake,
      suggesting a favorable efficacy profile. There was a randomized study pointing out that both
      sertraline and low-dose amitriptyline improved depressive symptoms in PD, and a significant
      benefit on quality of life was observed only with sertraline. Still, more studies are needed
      to demonstrate whether sertraline is effective to depression in PD patients. Further more,
      there is no trial about the efficacy and safety of sertraline on depression in PD in mainland
      China. It's necessary for us to initiate and conduct this trial in mainland China.
    

Intervention name(s): Sertraline
Intervention type(s): Drug
Intervention description(s): Starting dose 25mg/day for 1 week, then increasing to 50mg/day, add on 50mg each time when the depressive symptoms are not improved, at 2-week intervals. Maximum: 200mg/day. Maintenance: lowest effective dose.
Other intervention name(s): Zoloft
Intervention MeSH terms: Sertraline
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Parkinson's disease; depression; sertraline; intervention