Title: Escitalopram for Depression and Motor Symptoms in Parkinson’s Disease: A Systematic Review and Meta‑analysis
Authors: Vishnu V. Byroju, Jamir Pitton Rissardo, Jorge Patino, Ana Leticia Fornari Caprara, Andrew McGarry, Ian Walker
Conference: 2026 International Congress of Parkinson's Disease, Seoul, Korea
Objective
To evaluate the efficacy of escitalopram versus placebo for depressive symptoms, motor severity, and quality of life (QoL) in Parkinson’s disease (PD).
Background
Depression is highly prevalent in PD and contributes to disability and reduced QoL. Although selective serotonin reuptake inhibitors are frequently prescribed, evidence regarding the impact of escitalopram on mood and motor outcomes in PD remains inconsistent.
Design/Methods
A PRISMA‑compliant systematic search of PubMed, Embase, Cochrane Library, Scopus, Web of Science, PsycINFO, and CNKI identified randomized controlled trials (RCTs) comparing escitalopram with placebo in adults with PD. Outcomes included depressive symptoms [Hamilton Depression Rating Scale (HAM‑D), Beck’s Depression Inventory (BDI‑II), and Patient Health Questionnaire-9 (PHQ‑9)], motor severity [Unified Parkinson’s Disease Rating Scale III (UPDRS‑III)], and quality of life [Parkinson’s Disease Questionnaire-39 (PDQ‑39)]. Standardized mean differences (SMDs) or mean differences (MDs) were synthesized using random‑effects models (REML). Heterogeneity was assessed using I².
Results
Four RCTs (escitalopram n=124; placebo n=126) met inclusion criteria. Escitalopram improved depressive symptoms compared with placebo (SMD −1.25; 95% CI −2.33 to −0.16), but with very high heterogeneity (I²=92.1%). No significant effect was observed for UPDRS‑III (MD −2.18; 95% CI −11.11 to 6.76; I²=98%). QoL modestly improved with escitalopram (PDQ‑39 MD −6.47; 95% CI −10.83 to −2.11). Rates of adverse events, including constipation (RR 3.50, 95% CI 0.18–69.24), dyspepsia (RR 0.70, 95% CI 0.01–33.90), falls (RR 3.50, 95% CI 0.18–69.24), fatigue (RR 1.38, 95% CI 0.13–14.20), dizziness (RR 0.70, 95% CI 0.01–33.90), and insomnia (RR 0.23, 95% CI 0.01–5.45), did not differ meaningfully between groups.
Conclusions
Escitalopram may reduce depressive symptoms and improve QoL in PD, although the evidence is limited by small sample sizes, substantial heterogeneity, and imprecise estimates. Motor outcomes show no consistent effect. Larger, methodologically uniform RCTs are needed to clarify escitalopram’s efficacy and safety in PD.
Citation
Byroju V, Rissardo JP, Patino J, Caprara AL, McGarry A, Walker I. Escitalopram for Depression and Motor Symptoms in Parkinson’s Disease: A Systematic Review and Meta‑analysis. Mov Disord 2026;41(Suppl_1):S689.