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Background/Aim. Selective serotonin reuptake inhibitors are the most commonly  chosen antidepressants in patients with Parkinson's disease (PD). The aim of  our study was to assess the influence of fluoxetine (Flu) on motor functions  in patients with PD. Methods. In this prospective, controlled, open-label  study, 18 patients with PD and mild depression [(10 ≤ Hamilton Rating Scale  for Depression (HDRS) ≤ 23)] without dementia [(25 ≤ Mini-Mental State  Examination (MMSE)] were treated with Flu. Both single and repeated dose  effects of Flu were assessed on days 1-80. Plasma concentrations of Flu and  norfluoxetine (NORFlu) were correlated with the results of selected motor  function performance scores: The Unified Parkinsons Disease Rating Score  (UPDRS), Finger Tapping Test (FTT) and Purdue Pegboard Test (PPT). Severity  of PD, depression and dementia were evaluated using standard tests [(Hoehn  and Yahr stages (HY), activity of daily living (ADL), UPDRS, HDRS, MMSE)].  Results. Steady-state for Flu/NORFlu was reached after 18 days of treatment.  Such a plateau correlated with significant improvements in both scores of  depression and Parkinson's disability (HDRS, UPDRS and ADL, respectively). In  addition, FTT and PPT scores also increased until day 18, with further slight  fluctuations around the plateau. Optimal motor performances correlated with  Flu concentrations of approximately 60-110 μg/L. Conclusion. Flu (20 mg/day)  significantly reduced depression in PD patients while it did not impair their  motor performances. Because substantial placebo effects may arise in studies  of PD and depression, large, prospective, randomized, placebo-controlled  clinical trials are warranted. [Acknowledgment. Projekat Ministarstva nauke  Republike Srbije, br. 175090)

vojnosanitetski pregled

Fluoxetine does not impair motor function in patients with Parkinson's disease: Correlation between mood and motor functions with plasma concentrations of fluoxetine/norfluoxetine