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

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7 Citations (Scopus)

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-HT2A inverse agonist, pimavanserin, could be a better alternative in the treatment of PDP.

Original languageEnglish (US)
JournalBrain and Behavior
DOIs
StateAccepted/In press - 2017

Fingerprint

Psychotic Disorders
Antipsychotic Agents
Parkinson Disease
Retrospective Studies
Drug-Related Side Effects and Adverse Reactions
Therapeutics
olanzapine
Age of Onset
Serotonin 5-HT2 Receptor Agonists
Delusions
Risperidone
Selection Bias
Hallucinations
Movement Disorders
Sample Size
Quality of Life

Keywords

  • Adverse drug reactions
  • Antipsychotics
  • Parkinson's disease
  • Parkinson's disease psychosis

ASJC Scopus subject areas

  • Behavioral Neuroscience

Cite this

@article{c5f1172651d74dd585ad9500745f1e75,
title = "Atypical antipsychotic therapy in Parkinson's disease psychosis: A retrospective study",
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-HT2A inverse agonist, pimavanserin, could be a better alternative in the treatment of PDP.",
keywords = "Adverse drug reactions, Antipsychotics, Parkinson's disease, Parkinson's disease psychosis",
author = "Mei Yuan and Laura Sperry and Malhado-Chang, {Norika O} and Alexandra Duffy and Wheelock, {Vicki L} and {Tomaszewski Farias}, {Sarah E} and Kevin O'Connor and Olichney, {John M} and Kiarash Shahlaie and Lin Zhang",
year = "2017",
doi = "10.1002/brb3.639",
language = "English (US)",
journal = "Brain and Behavior",
issn = "2157-9032",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Atypical antipsychotic therapy in Parkinson's disease psychosis

T2 - A retrospective study

AU - Yuan, Mei

AU - Sperry, Laura

AU - Malhado-Chang, Norika O

AU - Duffy, Alexandra

AU - Wheelock, Vicki L

AU - Tomaszewski Farias, Sarah E

AU - O'Connor, Kevin

AU - Olichney, John M

AU - Shahlaie, Kiarash

AU - Zhang, Lin

PY - 2017

Y1 - 2017

N2 - 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-HT2A inverse agonist, pimavanserin, could be a better alternative in the treatment of PDP.

AB - 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-HT2A inverse agonist, pimavanserin, could be a better alternative in the treatment of PDP.

KW - Adverse drug reactions

KW - Antipsychotics

KW - Parkinson's disease

KW - Parkinson's disease psychosis

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U2 - 10.1002/brb3.639

DO - 10.1002/brb3.639

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SN - 2157-9032

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