Ziprasidone Versus Clozapine in the Treatment of Psychotic Symptoms in Parkinson Disease

Pintor, Luís; Valldeoriola, Francesc; Baillès, Eva; Martı́, Marı́a José; Muñiz, Armando; Tolosa, Eduard

doi:10.1097/wnf.0b013e31824d5115

Cited by 48 publications

(45 citation statements)

References 31 publications

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“…All other ADRs like dyskinesia and other psychotic reactions in parkinson disease were probably preventable due to poor predictability of ADRs and poorly understood mechanisms to explain their cause. [25][26][27] Majority of the reported ADRs were of mild severity and hence, there would be no strong indication to change or withhold the drug. This was similar to mild to moderate severity ADRs reported with trihexyphenidyl.…”

Section: Discussionmentioning

confidence: 99%

Adverse drug reaction to antiparkinson agents in Idiopathic Parkinson Disease: a prospective observational study in a Movement Disorder outpatient clinic

Thaha

Gangadhar

Iype

et al. 2017

Int J Basic Clin Pharmacol

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Background: Parkinson disease (PD) generally requires therapy for prolonged periods often with multiple drugs; drug-related adverse effects often add to the existing morbidity. Although, such ADRs are common, comprehensive information about their incidence, severity, and ultimate health effects are not available. The objective of the study was to analyze the pattern of occurrence of Adverse Drug Reactions (ADRs) in patients receiving anti-parkinson agents (APA) in a tertiary care hospital. We also aimed to assess the causality, severity and preventability of these ADRs.Methods: This prospective, observational study with 6 month follow up was conducted among consecutive PD patients receiving anti parkinson agents attending the Movement disorder clinic of Neurology department between April 1st 2011 and September 30th 2012. Tools used were ADR Reporting form of National Pharmacovigilance centre, WHO causality scale, Hartwig and Siegel scale to assess severity and Schumock and Thornton scale to assess preventability of ADRs. Descriptive statistics was used and the values were expressed in numbers and percentages.Results: ADRs were experienced in 87 patients (82.1%) out of 106 patients and most of these patients were on combination therapy (66%). No gender difference in distribution of ADRs was observed. The most common reactions were sedation, dizziness, dry mouth and fatigue. The drug usage was in the order of pramipexole (58.4%), levodopa+carbidopa (55.7%), trihexyphenidyl (28.3%), entacapone (5.7%) and amantadine (7.5%). Majority of the ADRs were mild level 1 (71.1%). ADR was maximum with entacapone. Majority of ADRs belonged to the causality possible ADR category. All the ADRs came under the definitely or probably preventable category.Conclusions: ADRs with antiparkinsonian drugs is common but mild and preventable.

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Section: Discussionmentioning

confidence: 99%

Adverse drug reaction to antiparkinson agents in Idiopathic Parkinson Disease: a prospective observational study in a Movement Disorder outpatient clinic

Thaha

Gangadhar

Iype

et al. 2017

Int J Basic Clin Pharmacol

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“…Likewise, olanzapine has been found to cause significant deterioration of motor function and has failed to consistently improve hallucinations [64,65]. Despite evidence for efficacy of ziprasidone [66], reports of worsened extrapyramidal symptoms also exist, as well as concern over prolonged QT interval [67,68]. Aripiprazole was also recently evaluated and resulted in worsening of parkinsonism, and is not recommended for us in PD psychosis [69].…”

Section: Psychosis In Pdmentioning

confidence: 99%

Treatment of Cognitive, Psychiatric, and Affective Disorders Associated with Parkinson's Disease

Connolly

Fox

2014

Neurotherapeutics

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Neuropsychiatric symptoms are common in Parkinson's disease (PD) and add significantly to the burden of disease. These symptoms are most commonly part of the disease spectrum owing to pathological changes within relevant brain regions. Neuropsychiatric problems include disorders of cognition, ranging from mild cognitive impairment to dementia, psychotic symptoms, including, most commonly, well-formed visual hallucinations and paranoid delusions, and mood disorders, such as depression and anxiety. The other common cause of neuropsychiatric problem is secondary to use of dopaminergic drugs. Some PD patients may develop behavioral disorders, including impulse control disorders (ICDs) and addictive symptoms. Psychosis can be due to a mixture of underlying pathology, with triggering or worsening of symptoms with changes to PD medications. Currently, management of these disorders primarily uses therapies developed for general psychiatry and cognitive neurology, rather than specifically for PD. However, significant adverse effects, such as worsening of the motor symptoms of PD, can limit use of some drug therapies. Identification of drug-induced symptoms, such as ICDs, enables withdrawal of the offending drug as the principal management strategy. Research is ongoing in an effort to develop more specific therapies for PD-related neuropsychiatric symptoms.

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“…Psychotic symptoms were significantly reduced in both groups, without worsening of motor symptoms. The results suggest a beneficial effect, however, better clinical trials will be necessary before recommending its use and understanding whether it will worsen PD motor symptoms [58].…”

Section: Clinical Evidencementioning

confidence: 95%

Parkinson’s Disease Psychosis: Therapy Tips and the Importance of Communication Between Neurologists and Psychiatrists

Martínez-Ramírez

Okun

Jaffee

2016

Neurodegener. Dis. Manag.

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Parkinson's disease (PD) is a chronic and complex neurodegenerative disorder resulting in a mixture of motor and nonmotor symptoms. Psychosis develops in around 60% of PD patients during and can be one of the most challenging nonmotor symptoms. PD psychosis is considered the single greatest precipitant for nursing home placement. PD psychosis is an independent predictor of increased mortality, and there is no 'ideal' or universal treatment strategy. The treatment approach to PD psychosis should be tailored and individualized for each patient. In this review, we will discuss PD psychosis and provide practical treatment considerations for neurologists, psychiatrists and other healthcare professionals. We stress the importance of real-time communication between members of the healthcare team.

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Ziprasidone Versus Clozapine in the Treatment of Psychotic Symptoms in Parkinson Disease

Abstract: Ziprasidone seems to be at least as effective as clozapine in the treatment to ameliorate psychotic symptoms in PD.

Cited by 48 publications

References 31 publications

Adverse drug reaction to antiparkinson agents in Idiopathic Parkinson Disease: a prospective observational study in a Movement Disorder outpatient clinic

Adverse drug reaction to antiparkinson agents in Idiopathic Parkinson Disease: a prospective observational study in a Movement Disorder outpatient clinic

Treatment of Cognitive, Psychiatric, and Affective Disorders Associated with Parkinson's Disease

Parkinson’s Disease Psychosis: Therapy Tips and the Importance of Communication Between Neurologists and Psychiatrists

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