Evidence map›Paper›PMID 30146591›Full record

Trial reportInternal medicine (Tokyo, Japan)2019

Antidepressants for Depression, Apathy, and Gait Instability in Parkinson's Disease: A Multicenter Randomized Study.

Makio Takahashi, Hayato Tabu, Akihiko Ozaki, Toshiaki Hamano, Takao Takeshima, REBORN study group

Open access · diamondAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Internal medicine (Tokyo, Japan), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 4 pooled it
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 72 citations in OpenAlex.

  1. Management of Anxiety in Parkinson's Disease.Movement disorders clinical practice · 2025
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Trial
  7. Article
  8. Towards the Prevention of Freezing of Gait in Parkinson's Disease.The European journal of neuroscience · 2026
    Review
  9. Review
  10. Review
  11. What is new in Freezing of Gait?Journal of neurology · 2026
    Review
  12. Review
  13. Article
  14. Review
  15. Article
  16. Review
  17. Neuropsychiatric disorders in Parkinson's disease.Therapeutic advances in neurological disorders · 2025
    Review
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Makio TakahashiDepartment of Neurology, Osaka Red Cross Hospital, Japan.
Hayato TabuDepartment of Neurology, Kitano Hospital, Japan.
Akihiko OzakiDepartment of Neurology, Osaka Saiseikai Nakatsu Hospital, Japan.
Toshiaki HamanoDepartment of Neurology, Kansai Electric Power Hospital, Japan.
Takao TakeshimaDepartment of Neurology, Tominaga Hospital, Japan.
REBORN study group
Kansai Electric Power Hospital · JPKitano Hospital · JPOsaka Red Cross Hospital · JPSaiseikai Nakatsu Hospital · JPTominaga hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective Depression, apathy, and gait instability are cardinal symptoms in patients with Parkinson's disease (PD). Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are used for treating the psychiatric symptoms of PD. This is the first prospective randomized study to compare the efficacy of an SNRI (duloxetine) with SSRIs (paroxetine, escitalopram) in improving depressive symptoms and apathy (primary) and freezing of gait (FOG; secondary) in patients with PD. Methods In this prospective, multicenter, open-label, randomized study, Japanese PD patients with a Quick Inventory of Depressive Symptomatology-Japanese (QIDS-J) score ≥6 were randomly assigned to receive an SSRI (27 enrolled, 25 analyzed) or duloxetine (28 enrolled, 27 analyzed) and were assessed at 6 and 10 weeks. Results The mean change (SD) in the QIDS J [SSRI -2.4 (3.6), p=0.015; SNRI -2.3 (3.9), p=0.029] and FOG-Questionnaire [SSRI -2.9 (4.2), p=0.012; SNRI -3.4 (4.7), p=0.010] scores (from baseline) at 10 weeks was statistically significant, while the mean change in the Apathy Scale scores was not [SSRI -2.7 (5.4), p=0.054; SNRI -1.5 (3.7), p=0.109]. No significant differences were observed between the SSRI and SNRI groups. The treatments were well-tolerated; however, gastrointestinal events were more common with SSRIs. Two SNRI-treated patients reported an exacerbation of tremor. Conclusion SSRIs and SNRIs improve the depressive symptoms and FOG in PD patients with mild to severe depressive symptoms. However, their effectiveness in treating apathy remains to be elucidated.

Indexed as

ApathyAdultAgedAged, 80 and overAntidepressive AgentsDepressive DisorderFemaleGait Disorders, NeurologicHumansMaleMiddle AgedNorepinephrineParkinson DiseaseProspective StudiesSelective Serotonin Reuptake InhibitorsAntidepressive AgentsNorepinephrineSelective Serotonin Reuptake Inhibitorsapathydepressiongait instabilityParkinson's diseaseserotonin and noradrenaline reuptake inhibitorsserotonin uptake inhibitors

Identifiers

PMID30146591
PMCPMC6395136
OpenAlexW2888130307

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.