TY - JOUR
T1 - Pimavanserin use in a movement disorders clinic
T2 - a single-center experience
AU - Mahajan, Abhimanyu
AU - Bulica, Bisena
AU - Ahmad, Ayesha
AU - Kaminski, Patricia
AU - LeWitt, Peter
AU - Taylor, Danette
AU - Krstevska, Shana
AU - Patel, Neepa
N1 - Funding Information:
This study was approved by the Henry Ford Institutional Review Board. Abhimanyu Mahajan, Bisena Bulica, Ayesha Ahmad, Patricia Kaminski, Danette Taylor, and Shana Krstevska report no conflicts of interest. Dr. LeWitt is a consultant for Acorda Therapeutics; Adamas; Britannia; Intec Pharma; Jazz Pharmaceuticals; Lundbeck; Merz; NeuroDerm Ltd.; Pfizer; Prexton; Sage; Scion; Sunovion; SynAgile. He receives lecture fees from Acadia; Lundbeck; US WorldMeds. He also has research grant support from AcordaTherapeutics; Adamas; Bioelectron Technology Corporation; Biotie Therapies; Intec Pharma; Lundbeck; Michael J. Fox Foundation for Parkinson?s Research; Parkinson Study Group; Sunovion; US WorldMeds. Dr. Patel has received honoraria as a consultant for Acadia pharmaceuticals and as a speaker for Teva pharmaceuticals.
Funding Information:
Conflict of interest Abhimanyu Mahajan, Bisena Bulica, Ayesha Ahmad, Patricia Kaminski, Danette Taylor, and Shana Krstevska report no conflicts of interest. Dr. LeWitt is a consultant for Acorda Therapeutics; Adamas; Britannia; Intec Pharma; Jazz Pharmaceuticals; Lundbeck; Merz; NeuroDerm Ltd.; Pfizer; Prexton; Sage; Scion; Sunovion; SynAgile. He receives lecture fees from Acadia; Lundbeck; US WorldMeds. He also has research grant support from AcordaTherapeutics; Adamas; Bioelectron Technology Corporation; Biotie Therapies; Intec Pharma; Lundbeck; Michael J. Fox Foundation for Parkinson’s Research; Parkinson Study Group; Sunovion; US WorldMeds. Dr. Patel has received honoraria as a consultant for Acadia pharmaceuticals and as a speaker for Teva pharmaceuticals.
Publisher Copyright:
© 2018, Springer-Verlag Italia S.r.l., part of Springer Nature.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Background: Parkinson’s disease psychosis (PDP) is a disabling non-motor symptom of Parkinson’s disease (PD) that is challenging to treat. Dopamine receptor blockers (DRB) are used to treat PDP, though these may be associated with adverse effects, including worsening of Parkinsonism. Pimavanserin, a selective 5-HT2A receptor inverse agonist, was recently FDA-approved for treatment of PDP; however, there is limited information on its long-term use in PDP patients. Methods: A retrospective chart review of patients prescribed pimavanserin was performed in August, 2017. Data on demographics, psychotic features, sleep, and adverse effects was collected using a semi-structured telephone interview with patients or caregivers. Hallucination severity (HS) was quantified as mild (< 1 episode/week), moderate (1/week to < 1/day), or severe (daily/continuous). Results: Seventeen patients consented to participate in the study; 16 were diagnosed with PDP, 1 with Lewy body dementia. Fourteen had co-morbid cognitive impairment/dementia. The mean duration of Parkinsonism was 11.8 ± 8.0 years, with 2.6 ± 1.9 years of psychosis. Eleven of the seventeen patients reported improvement of hallucinations of which 5/8 were initiated on pimavanserin monotherapy, and 6/9 reported improvement of HS with combination of DRB. Six of nine patients prescribed DRB were able to discontinue this medication after introduction of pimavanserin. Four patients discontinued medications (2, no benefit; 1, spontaneous resolution; 1, cost). No major side effects were reported, and two patients noted subjective improvement of sleep. Conclusion: In our series based on a small sample size, pimavanserin is well-tolerated and effective as both monotherapy and adjuvant treatment for moderate to severe. This medication can facilitate reduction or cessation of DRB medication.
AB - Background: Parkinson’s disease psychosis (PDP) is a disabling non-motor symptom of Parkinson’s disease (PD) that is challenging to treat. Dopamine receptor blockers (DRB) are used to treat PDP, though these may be associated with adverse effects, including worsening of Parkinsonism. Pimavanserin, a selective 5-HT2A receptor inverse agonist, was recently FDA-approved for treatment of PDP; however, there is limited information on its long-term use in PDP patients. Methods: A retrospective chart review of patients prescribed pimavanserin was performed in August, 2017. Data on demographics, psychotic features, sleep, and adverse effects was collected using a semi-structured telephone interview with patients or caregivers. Hallucination severity (HS) was quantified as mild (< 1 episode/week), moderate (1/week to < 1/day), or severe (daily/continuous). Results: Seventeen patients consented to participate in the study; 16 were diagnosed with PDP, 1 with Lewy body dementia. Fourteen had co-morbid cognitive impairment/dementia. The mean duration of Parkinsonism was 11.8 ± 8.0 years, with 2.6 ± 1.9 years of psychosis. Eleven of the seventeen patients reported improvement of hallucinations of which 5/8 were initiated on pimavanserin monotherapy, and 6/9 reported improvement of HS with combination of DRB. Six of nine patients prescribed DRB were able to discontinue this medication after introduction of pimavanserin. Four patients discontinued medications (2, no benefit; 1, spontaneous resolution; 1, cost). No major side effects were reported, and two patients noted subjective improvement of sleep. Conclusion: In our series based on a small sample size, pimavanserin is well-tolerated and effective as both monotherapy and adjuvant treatment for moderate to severe. This medication can facilitate reduction or cessation of DRB medication.
KW - Hallucinations
KW - Parkinson’s disease
KW - Parkinson’s disease psychosis
KW - Pimavanserin
UR - http://www.scopus.com/inward/record.url?scp=85050188841&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050188841&partnerID=8YFLogxK
U2 - 10.1007/s10072-018-3500-5
DO - 10.1007/s10072-018-3500-5
M3 - Article
C2 - 30032332
AN - SCOPUS:85050188841
SN - 1590-1874
VL - 39
SP - 1767
EP - 1771
JO - Neurological Sciences
JF - Neurological Sciences
IS - 10
ER -