Selective Serotonin Reuptake Inhibitors Effect on Motor Function in Subjects with Parkinson’s Disease and Depression

Depression associated with Parkinson’s disease (PD) is very common and by some estimates, affects 40%-50% of that population. The majority of these patients are treated with a selective serotonin reuptake inhibitor (SSRI). However, extrapyamidal adverse reactions are a side-effect of this medication and by causing inhibition of the dopaminergic path way, these medications could potentially worsen PD as measured by the Unified Parkinson’s Disease Rating Scale (UPDRS). Hypothesis was that SSRIs would cause a statistically significant increase in the motor part of the UPDRS. This is a systematic review of the literature. An exhaustive search concerning Parkinson’s disease and SSRIs, with specific attention to motor aspect of the disease, was undertaken using four different search engines. Though randomized, double-blinded, placebo controlled studies were lacking, six articles met the criteria and were evaluated in this review. Results show that SSRIs, do not worsen the motor part of the UPDRS with statistical significance in the short term, but can cause increased tremor for a minority of the patients. SSRIs are relatively safe in this population but will exacerbate motor symptoms at a higher incidence than the general population. The SSRIs, sertraline and citalopram, appear to be the best tolerated. Increased awareness should be given to patients with Parkinson’s disease being treated with a selective serotonin reuptake inhibitor to manage their depression. Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor James Ferguson, PA-C Second Advisor Rob Rosenow PharmD, OD Third Advisor Annjanette Sommers MS, PA-C