Atypical antipsychotic therapy in Parkinson's disease psychosis: A retrospective study - PubMed (original) (raw)

. 2017 Apr 14;7(6):e00639.

doi: 10.1002/brb3.639. eCollection 2017 Jun.

Affiliations

Atypical antipsychotic therapy in Parkinson's disease psychosis: A retrospective study

Mei Yuan et al. Brain Behav. 2017.

Abstract

Objective: Parkinson's disease psychosis (PDP) is a frequent complication of idiopathic Parkinson's disease (iPD) with significant impact on quality of life and association with poorer outcomes. Atypical antipsychotic drugs (APDs) are often used for the treatment of PDP; however, their use is often complicated by adverse drug reactions (ADRs). In this study, we present patients with PDP who were treated with the most commonly used atypical antipsychotic agents and review their respective ADRs.

Methods: A retrospective study was carried out to include a total of 45 patients with iPD who visited a movement disorders clinic between 2006 and 2015. All PDP patients treated with atypical APDs were included in the analysis for their specific ADRs.

Results: Forty-five iPD patients (mean age of onset: 62.67 ± 9.86 years) were included, of those 10 patients had psychosis (mean age of onset: 76.80 ± 4.61 years). Of the 45 patients, 22.2% were found to have psychotic symptoms, of whom 70% had hallucinations, 20% had delusions, and 10% illusions. Seventy percent of psychotic symptoms occurred after ten or more years from diagnosis of iPD. PDP patients were treated with quetiapine, olanzapine, and risperidone separately or in combination, all of which were found to have certain ADRs.

Limitations: This study was limited by its retrospective study design and small sample size and with likely selection bias.

Conclusions: The prevalence of PDP is relatively high in older patients with iPD. The uses of the currently available atypical APDs in this patient population are often complicated by ADRs. The selective 5-HT 2A inverse agonist, pimavanserin, could be a better alternative in the treatment of PDP.

Keywords: Parkinson's disease; Parkinson's disease psychosis; adverse drug reactions; antipsychotics.

PubMed Disclaimer

References

    1. Bizzarri, J. V. , Giupponi, G. , Maniscalco, I. , Schroffenegger, P. , Conca, A. , & Kapfhammer, H. P. (2015). Parkinson's disease and psychoses. Neuropsychiatric, 29, 1–13. -PubMed
    1. Cummings, J. , Isaacson, S. , Mills, R. , & Ballard, C. (2014). Pimavanserin for patients with Parkinson's disease psychosis: A randomised, placebo‐controlled phase 3 trial. Lancet, 383, 533–540. -PubMed
    1. Fénelon, G. , & Alves, G. (2010). Epidemiology of psychosis in Parkinson's disease. Journal of the Neurological Sciences, 289, 12–17. -PubMed
    1. Fernandez, H. H. , Lapane, K. L. , Ott, B. R. , & Friedman, J. H. (2000). Gender differences in the frequency and treatment of behavior problems in Parkinson's disease. Movement Disorders, 15, 490–496. -PubMed
    1. Fernandez, H. H. , Trieschmann, M. E. , & Friedman, J. H. (2003). The treatment of psychosis in Parkinson's disease: Safety considerations. Drug Safety, 26, 643–659. -PubMed

MeSH terms

Substances

LinkOut - more resources