Pimavanserin for Psychotic Symptoms in People With Parkinsonism: A Second Chart Review.

Abstract

INTRODUCTION:

Pimavanserin (Pim) is a 5HT2A inverse agonist that is the only Food and Drug Administration-approved treatment for Parkinson disease (PD) psychosis. The published open-label experience is limited.

METHODS:

This report is a chart review of all patients who were started on the drugs since the one earlier report on 15 patients. All patients were included, whether or not they completed 6 weeks of treatment, the time required for maximum benefit found in the published phase 3 trial.

RESULTS:

Twenty-six patients are reported. Three patients had dementia with Lewy bodies; one had an atypical parkinsonism; 22 had PD, including one with schizophrenia and neuroleptic exacerbated, dopamine transporter scan-positive idiopathic PD; and another had PD complicated by strokes. Six stopped before 6 weeks due to adverse effects, including 1 with worsened psychosis. Eighteen completed at least 6 weeks of treatment. Of these, 3 stopped due to lack of efficacy and 3 due to worsened psychosis. Twelve found it helpful. Of the 18 who took Pim for at least 6 weeks, 12 improved and continue to take it.

CONCLUSIONS:

Almost 50% of parkinsonian patients with psychotic symptoms found Pim to be a useful medication, which they continue to take. Reasons for intolerance varied and were thought to be unrelated to the drug.

• Authors: Joseph H Friedman
• Journal: Clinical neuropharmacology (Clin Neuropharmacol) 2018 Sep/Oct Vol. 41 Issue 5 Pg. 156-159 ISSN: 1537-162X [Electronic] United States
• PMID: 30004964 (Publication Type: Journal Article)

Chemical References

• Antipsychotic Agents
• Piperidines
• Serotonin 5-HT2 Receptor Agonists
• Urea
• pimavanserin

Topics

• Aged
• Aged, 80 and over
• Antipsychotic Agents (therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Parkinson Disease (drug therapy, psychology)
• Piperidines (therapeutic use)
• Psychotic Disorders (drug therapy, etiology)
• Retrospective Studies
• Serotonin 5-HT2 Receptor Agonists (therapeutic use)
• Urea (analogs & derivatives, therapeutic use)