ObjectiveTo systematically review the efficacy and safety of selective serotonin reuptake inhibitors (SSRIs) in the treatment of Parkinson's disease patients with depression. MethodsThe Cochrane Library (Issue 5, 2014), PubMed, EMbase, CNKI, VIP and WanFang Data databases were searched from inception to May 2014 for randomized controlled trials (RCTs) investigating the efficacy and safety of SSRIs for Parkinson's disease patients with depression. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 12 RCTs were included. The results of meta-analysis showed that the efficacy of SSRIs was better than placebo (RR=2.18, 95%CI 1.60 to 2.97, P<0.000 01) and the dropouts rates of SSRIs were higher than placebo (OR=3.02, 95%CI 1.04 to 8.79, P=0.04). However, the incidence rate of adverse events between the SSRIs group and the placebo group was not statistically different. ConclusionCurrent evidence indicates that SSRIs are effective for the Parkinson's disease patients with depression. Because of the limitation of quantity and quality of included studies, large-scale multi-center RCTs are required to confirm these findings.
ObjectiveTo systematically review the antidepressant efficacy of selective serotonin re-uptake inhibitors (SSRIs) and their effect on inflammatory factors in adults with major depressive disorder (MDD). MethodsElectronic searches were conducted in PubMed, Embase, Web of Science Core Collection, ProQuest, JSTOR, PsycINFO, The Cochrane Library, Epistemonikos, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Literature Database (CBM) from database inception to December 31, 2024. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was performed using R 4.4.2 software. ResultsA total of 62 controlled studies (including 63 reports) was included, consisting of 36 randomized controlled trials (RCTs), 4 non-randomized controlled trials (NRCTs), and 23 case-control studies. Meta-analysis showed that the overall antidepressant effect size of SSRIs was SMD −3.18, 95%CI −3.56 to −2.80, with no statistically significant difference in efficacy between different SSRIs (Q=6.77, P=0.24). However, their antidepressant efficacy was influenced by the country of origin of the study participants and the duration of intervention. SSRIs exerted significant inhibitory effects on 17 pro-inflammatory factors, but with high heterogeneity. SSRIs had no significant overall effect on anti-inflammatory factors (SMD 0.81, 95%CI −0.20 to 1.82). However, subgroup analysis revealed that escitalopram exerted significant promoting effects on IL-10 (SMD 1.11, 95%CI 0.61 to1.60) and IL-13 (SMD 2.40, 95%CI 1.84 to 2.95). ConclusionSSRIs are effective antidepressants but vary in their effects on inflammatory factors. Among them, escitalopram has a potential bidirectional regulatory effect on inflammatory factors, and more high-quality multicenter studies are needed in the future for verification..