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J Neurol Neurosurg Psychiatry 2009;80:671-674 doi:10.1136/jnnp.2008.152983
  • Short report

Use of antidepressants and the risk of Parkinson’s disease: a prospective study

  1. A Alonso1,
  2. L A García Rodríguez2,
  3. G Logroscino3,
  4. M A Hernán4
  1. 1
    Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, USA
  2. 2
    Spanish Centre for Pharmacoepidemiologic Research, Madrid, Spain
  3. 3
    Department of Neuroscience, University of Bari, Bari, Italy
  4. 4
    Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
  1. Dr A Alonso, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S Second St, Suite 300, Minneapolis, MN 55416, USA; aalogut{at}alumni.unav.es
  • Received 29 April 2008
  • Revised 22 July 2008
  • Accepted 7 August 2008

Abstract

Background: Individuals with depression have a higher risk of Parkinson’s disease (PD) but the timing of the association is unknown. Therefore, the relationship between initiation of antidepressant therapy and PD risk was assessed in a large population based database from the UK and the timing of this association was explored.

Methods: A case control study nested in the General Practice Research Database cohort, a large computerised database with clinical information from more than 3 million individuals in the UK, was conducted. Cases of PD were identified from the computer records from 1995 to 2001 and matched with up to 10 controls by age, sex and practice. Use of antidepressants was obtained from the computer records.

Results: 999 PD cases and 6261 controls were included. The rate ratio (RR) and 95% CI of PD in initiators of antidepressant therapy compared with non-initiators was 1.85 (1.25 to 2.75). The association was stronger during the first 2 years after initiation of medication use (RR 2.19; 95% CI 1.38 to 3.46) than later (RR 1.23; 95% CI 0.57 to 2.67). Results were similar for selective serotonin reuptake inhibitors and tricyclic antidepressants separately.

Conclusion: Initiation of any antidepressant therapy was associated with a higher risk of PD in the 2 years after the start of treatment, which suggests that depressive symptoms could be an early manifestation of PD, preceding motor dysfunction.

Footnotes

  • Funding: This study was supported by grant R01/HL080644 from NIH.

  • Competing interests: None.

  • Ethics approval: The study was approved by the Institutional Review Board at Harvard School of Public Health.

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