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The Efficacy and Safety of Antipsychotic Medications in the Treatment of Psychosis in Patients with Parkinson's Disease

Psychotic symptoms are present in up to 50% of patients with Parkinson's disease. These symptoms have detrimental effects on patients' and caregivers' quality of life and may predict mortality. The pathogenesis of psychotic symptoms in Parkinson's disease is complex, but the use...

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Autores principales: Divac, Nevena, Stojanović, Radan, Savić Vujović, Katarina, Medić, Branislava, Damjanović, Aleksandar, Prostran, Milica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967673/
https://www.ncbi.nlm.nih.gov/pubmed/27504054
http://dx.doi.org/10.1155/2016/4938154
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author Divac, Nevena
Stojanović, Radan
Savić Vujović, Katarina
Medić, Branislava
Damjanović, Aleksandar
Prostran, Milica
author_facet Divac, Nevena
Stojanović, Radan
Savić Vujović, Katarina
Medić, Branislava
Damjanović, Aleksandar
Prostran, Milica
author_sort Divac, Nevena
collection PubMed
description Psychotic symptoms are present in up to 50% of patients with Parkinson's disease. These symptoms have detrimental effects on patients' and caregivers' quality of life and may predict mortality. The pathogenesis of psychotic symptoms in Parkinson's disease is complex, but the use of dopaminergic medications is one of the risk factors. The treatment of psychotic symptoms in Parkinson's disease is complicated due to the ability of antipsychotic medications to worsen motor symptoms. The efficacy of clozapine in the treatment of psychosis in patients with Parkinson's disease has been confirmed in several clinical trials; however, the adverse effects and the necessity of blood count monitoring are the reasons why the use of this drug is challenging. The studies on safety and efficacy of other antipsychotics conflicting results. The use of antipsychotics in these patients is also associated with increased mortality. Psychotic symptoms in Parkinson's disease per se are also proven predictors of mortality. Thus it is necessary to treat psychotic symptoms but the choice of an antipsychotic should be based on careful risk/benefit assessment. Pimavanserin as a novel therapeutic option with more favorable adverse effects profile is now available for this indication, but careful postmarketing monitoring is necessary to establish the true picture of this drug's long-term safety and efficacy.
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spelling pubmed-49676732016-08-08 The Efficacy and Safety of Antipsychotic Medications in the Treatment of Psychosis in Patients with Parkinson's Disease Divac, Nevena Stojanović, Radan Savić Vujović, Katarina Medić, Branislava Damjanović, Aleksandar Prostran, Milica Behav Neurol Review Article Psychotic symptoms are present in up to 50% of patients with Parkinson's disease. These symptoms have detrimental effects on patients' and caregivers' quality of life and may predict mortality. The pathogenesis of psychotic symptoms in Parkinson's disease is complex, but the use of dopaminergic medications is one of the risk factors. The treatment of psychotic symptoms in Parkinson's disease is complicated due to the ability of antipsychotic medications to worsen motor symptoms. The efficacy of clozapine in the treatment of psychosis in patients with Parkinson's disease has been confirmed in several clinical trials; however, the adverse effects and the necessity of blood count monitoring are the reasons why the use of this drug is challenging. The studies on safety and efficacy of other antipsychotics conflicting results. The use of antipsychotics in these patients is also associated with increased mortality. Psychotic symptoms in Parkinson's disease per se are also proven predictors of mortality. Thus it is necessary to treat psychotic symptoms but the choice of an antipsychotic should be based on careful risk/benefit assessment. Pimavanserin as a novel therapeutic option with more favorable adverse effects profile is now available for this indication, but careful postmarketing monitoring is necessary to establish the true picture of this drug's long-term safety and efficacy. Hindawi Publishing Corporation 2016 2016-07-18 /pmc/articles/PMC4967673/ /pubmed/27504054 http://dx.doi.org/10.1155/2016/4938154 Text en Copyright © 2016 Nevena Divac et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Divac, Nevena
Stojanović, Radan
Savić Vujović, Katarina
Medić, Branislava
Damjanović, Aleksandar
Prostran, Milica
The Efficacy and Safety of Antipsychotic Medications in the Treatment of Psychosis in Patients with Parkinson's Disease
title The Efficacy and Safety of Antipsychotic Medications in the Treatment of Psychosis in Patients with Parkinson's Disease
title_full The Efficacy and Safety of Antipsychotic Medications in the Treatment of Psychosis in Patients with Parkinson's Disease
title_fullStr The Efficacy and Safety of Antipsychotic Medications in the Treatment of Psychosis in Patients with Parkinson's Disease
title_full_unstemmed The Efficacy and Safety of Antipsychotic Medications in the Treatment of Psychosis in Patients with Parkinson's Disease
title_short The Efficacy and Safety of Antipsychotic Medications in the Treatment of Psychosis in Patients with Parkinson's Disease
title_sort efficacy and safety of antipsychotic medications in the treatment of psychosis in patients with parkinson's disease
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967673/
https://www.ncbi.nlm.nih.gov/pubmed/27504054
http://dx.doi.org/10.1155/2016/4938154
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