Department of Neurology, Jilin Province FAW General Hospital, 130021 Changchun, Jilin, China.
Department of Cardiology, Jilin Province FAW General Hospital, 130021 Changchun, Jilin, China.
Actas Esp Psiquiatr. 2024 Oct;52(5):607-615. doi: 10.62641/aep.v52i5.1634.
Parkinson's disease (PD) is a neurodegenerative disorder characterized by both motor and non-motor symptoms, including depression, which significantly impacts the quality of life of affected individuals. This study aims to investigate the real-world effectiveness and safety of duloxetine in treating comorbid depression in patients with Parkinson's disease and to compare its outcomes with traditional treatment approaches.
This study included adult patients diagnosed with Parkinson's disease combined with depression from December 2020 to December 2023. Based on the use of duloxetine, the cohort was divided into a traditional treatment group and a duloxetine group (traditional treatment combined with duloxetine). Patients with incomplete medical records, concurrent antidepressant therapy, or major psychiatric or neurological disorders were excluded. Retrospective data, including demographic information, treatment adherence, and various assessment scores, were collected from medical records by trained research staff.
In total, 106 patients were analyzed, with 50 patients receiving traditional treatment and 56 patients receiving duloxetine. The duloxetine group exhibited significantly lower scores than the traditional treatment group in the Unified PD Rating Scale (p = 0.015), Hamilton Depression Rating Scale (p = 0.013), Beck Depression Inventory (p = 0.031), Parkinson's disease Questionnaire-39 (p = 0.006), and Clinical Global Impression-Improvement (p < 0.001) scores. In motor function assessment, the duloxetine group demonstrated improvements in kinetic tremor scores (p = 0.017), gait speed (p < 0.001), Timed Up and Go Test performance (p < 0.001), dyskinesia severity (p = 0.017), and rigidity (p = 0.019) compared to the traditional treatment group. Additionally, the duloxetine group exhibited better cognitive function across various assessments, including the Symbol Digit Modalities Test (p = 0.024), Stroop Color-Word Test (p = 0.048), and Montreal Cognitive Assessment (p = 0.024).
Duloxetine is associated with superior efficacy in improving motor and non-motor symptoms, overall clinical status, and cognitive function. These findings support the potential utility of duloxetine as a comprehensive treatment option for comorbid depression in Parkinson's disease.
帕金森病（PD）是一种神经退行性疾病，其特征是既有运动症状又有非运动症状，包括抑郁症，这极大地影响了患者的生活质量。本研究旨在探究度洛西汀治疗帕金森病合并抑郁症的真实世界疗效和安全性，并与传统治疗方法进行比较。
本研究纳入了 2020 年 12 月至 2023 年 12 月期间被诊断为帕金森病合并抑郁症的成年患者。根据度洛西汀的使用情况，将队列分为传统治疗组和度洛西汀组（传统治疗联合度洛西汀）。排除病历资料不完整、同时接受抗抑郁治疗或伴有严重精神或神经疾病的患者。由经过培训的研究人员从病历中收集了包括人口统计学信息、治疗依从性和各种评估评分在内的回顾性数据。
共分析了 106 例患者，其中 50 例接受传统治疗，56 例接受度洛西汀治疗。与传统治疗组相比，度洛西汀组在统一帕金森病评定量表（p = 0.015）、汉密尔顿抑郁评定量表（p = 0.013）、贝克抑郁量表（p = 0.031）、帕金森病问卷-39（p = 0.006）和临床总体印象-改善（p < 0.001）评分方面的得分显著更低。在运动功能评估方面，度洛西汀组的运动性震颤评分（p = 0.017）、步态速度（p < 0.001）、计时起立行走测试表现（p < 0.001）、运动障碍严重程度（p = 0.017）和僵直度（p = 0.019）方面的改善明显优于传统治疗组。此外，度洛西汀组在各种认知评估中表现出更好的认知功能，包括符号数字模态测验（p = 0.024）、斯特鲁普颜色-文字测验（p = 0.048）和蒙特利尔认知评估（p = 0.024）。
度洛西汀在改善运动和非运动症状、整体临床状况和认知功能方面具有更好的疗效。这些发现支持度洛西汀作为帕金森病合并抑郁症综合治疗选择的潜力。
