Objective: The aim of this study was to explore the effects of Angiotensin II Type 1 receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) on anxiety and depression in PD.

Background: Mood disorders, including depression and anxiety, are often disturbing symptoms of Parkinson’s disease (PD). Various studies suggest that the cerebral Renin-Angiotensin System (RAS) might have a role in anxiety and depression development.

Method: Four hundred and twenty-three newly diagnosed PD patients free from antiparkinsonian treatment entered the study. Of them, 12 were treated with ARBs and 42 with ACE-Is. All 423 participants were evaluated using the State-Trait Anxiety Inventory (STAI) and Geriatric Depression Scale (GDS-15) tests and were monitored at baseline and for up to 5 years.

Results: At the beginning of the study (baseline visit), ARB-treated patients had lower anxiety STAI scores than those on ACE-Is or drug-free (Means ± standard errors= 17.2±1.3 vs. 21.3±1.3, or 23.8±0.5 respectively, p=0.021, ANOVA). Depression GDS scores were comparable across all groups, v.g., ARB-treated, ACE-I-treated, and untreated patients (Means ± standard errors= 1.8±0.4 vs. 2.2±0.3, and 2.3±0.11 respectively, p=0.863, ANOVA on logtransformed values). ARB-treated patients had lower STAI scores compared with the rest of the patients in the first and third follow-up years (p<0.01 and p=0.05, respectively). ACE-Is had no measurable effects. Depression scores were unaffected by any of the drugs throughout the study.

Conclusion: In our study, ARB-treatment reduced anxiety in PD. These results reinforce the suggested link between an abnormal RAS function and the development of this frequent symptom and warrant randomized clinical trials.

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