Comparative Analysis of the Effects of Escitalopram, Pramipexole, and Transcranial Magnetic Stimulation on Depression in Patients With Parkinson Disease: An Open-Label Randomized Controlled Trial

Clin Neuropharmacol. 2022 Jul-Aug;45(4):84-88. doi: 10.1097/WNF.0000000000000507. Epub 2022 Feb 1.


Objective: This study aimed to compare the effects of different antidepressant therapies on depression in patients with Parkinson disease (PD) and to provide a reference for clinical treatment.

Methods: A total of 328 patients with idiopathic PD were selected consecutively. Subjects met Diagnostic and Statistical Manual of Mental Disease , Fourth Edition , criteria for a depressive disorder, or operationally defined subsyndromal depression, and scored greater than 17 on the 17-item Hamilton Depression Scale (HAMD-17). One hundred thirty-one patients with PD accompanied with depression were enrolled into the experimental group. The subjects were randomly divided into 4 groups, and 118 were eventually completed: routine treatment group (n = 29), routine treatment + escitalopram group (n = 29), routine treatment + pramipexole group (n = 31), and routine treatment + transcranial magnetic stimulation (TMS) group (n = 29). After 4 weeks of treatments, the efficacy of each treatment was evaluated using HAMD score and reduction rate.

Results: After 4 weeks of treatment, the HAMD score was used for pair-to-pair comparison between the 4 groups. The therapeutic efficiency of escitalopram, pramipexole, and repetitive TMS was superior to routine anti-PD treatment, and the differences were statistically significant ( P < 0.05). There was no statistical difference between escitalopram and pramipexole, but all of them were superior to rTMS. Further logistic regression analysis suggested that 50% reduction in HAMD score from baseline was associated with the treatment method. Among them, escitalopram had statistical significance ( P < 0.05).

Conclusions: Escitalopram, pramipexole, and high-frequency TMS had better efficacy in patients with PD complicated with depression. At 4 weeks, escitalopram showed better antidepressant effects and improved patients' quality of life and did not worsen motor function.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Antidepressive Agents / therapeutic use
  • Citalopram* / therapeutic use
  • Depression / drug therapy
  • Depression / etiology
  • Double-Blind Method
  • Escitalopram
  • Humans
  • Parkinson Disease* / complications
  • Parkinson Disease* / drug therapy
  • Pramipexole / therapeutic use
  • Quality of Life
  • Transcranial Magnetic Stimulation / methods
  • Treatment Outcome


  • Antidepressive Agents
  • Citalopram
  • Escitalopram
  • Pramipexole