In a retrospective analysis, Morrow et al. (2024) utilized data from the Parkinson's Progression Markers Initiative (PPMI) to investigate the association between the initiation of antidepressant use and the development of impulse control disorder (ICD) in patients with Parkinson's disease (PD). The study included participants from the PPMI PD cohort with a primary diagnosis of idiopathic PD.

The researchers utilized the Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease (QUIP) to capture the presence of ICD and defined antidepressant use based on medication logs for each participant. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). The analysis involved 1,045 individuals.

The findings revealed a significant increase in the probability of ICD among individuals exposed to serotonergic antidepressants compared to those not exposed. The Log-rank test showed a p-value of less than 0.001, indicating a statistically significant difference. After adjusting for various factors such as dopamine agonist use, depression, bupropion use, MAOI-B use, amantadine use, LEDD, disease duration, sex, and age, serotonergic antidepressant use was associated with a hazard ratio for ICD of 1.4 (95% CI 1.0 – 1.8, z-value 2.1, p = 0.04).

In conclusion, the study suggests a temporal association between the use of serotonergic antidepressants and the development of impulse control disorder in patients with Parkinson's disease. The results highlight the importance of further investigation into the relationship between antidepressant medications and non-motor symptoms, such as impulse control disorders, in PD patients.

Reference:
Morrow CB et al., Am J Geriatr Psychiatry. Published online January 3, 2024:S1064-7481(23)00530-4. Abstract