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Rivastigmine for minor visual hallucinations in Parkinson's disease: A randomized controlled trial with 24 months follow‐up

BACKGROUND: Visual hallucinations are common in patients with Parkinson's disease and represent probably the major independent predictor for cognitive deterioration and nursing home placement. OBJECTIVE: To investigate if treatment of minor visual hallucinations in Parkinson's disease with...

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Autores principales: van Mierlo, Tom J. M., Foncke, Elisabeth M. J., Post, Bart, Schmand, Ben A., Bloem, Bastiaan R., van Harten, Barbera, Tissingh, Gerrit, Munts, Alexander G., de Haan, Rob J., de Bie, Rob M. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413762/
https://www.ncbi.nlm.nih.gov/pubmed/34291590
http://dx.doi.org/10.1002/brb3.2257
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author van Mierlo, Tom J. M.
Foncke, Elisabeth M. J.
Post, Bart
Schmand, Ben A.
Bloem, Bastiaan R.
van Harten, Barbera
Tissingh, Gerrit
Munts, Alexander G.
de Haan, Rob J.
de Bie, Rob M. A.
author_facet van Mierlo, Tom J. M.
Foncke, Elisabeth M. J.
Post, Bart
Schmand, Ben A.
Bloem, Bastiaan R.
van Harten, Barbera
Tissingh, Gerrit
Munts, Alexander G.
de Haan, Rob J.
de Bie, Rob M. A.
author_sort van Mierlo, Tom J. M.
collection PubMed
description BACKGROUND: Visual hallucinations are common in patients with Parkinson's disease and represent probably the major independent predictor for cognitive deterioration and nursing home placement. OBJECTIVE: To investigate if treatment of minor visual hallucinations in Parkinson's disease with rivastigmine delays the progression to psychosis. METHODS: A multicenter, randomized, double‐blind, placebo‐controlled trial was conducted which aimed to recruit 168 patients with Parkinson's disease reporting minor visual hallucinations 4 weeks before it. Important exclusion criteria were Parkinson's disease dementia, current delirium, and treatment with antipsychotics or drugs that have significant anti‐cholinergic side effects. Subjects were randomized to rivastigmine capsules, 3–6 mg twice a day, or placebo for 24 months. The primary outcome was the time to Parkinson's disease psychosis, which was defined as the need to start with antipsychotics. RESULTS: The trial was stopped prematurely because of slow recruitment. Ninety‐one patients were randomized: 46 patients were assigned to rivastigmine and 45 patients to placebo. No effect of rivastigmine could be demonstrated on the transition time to psychosis or dementia during the 24‐month follow‐up period. After 6 months of study treatment, cognition, mood, motor performance, and non‐motor performance did not differ significantly between the rivastigmine‐group and the placebo‐group. CONCLUSIONS: Because the study was terminated early, it was insufficiently powered to properly evaluate the primary outcome. The limited data of the study favor a wait and see approach instead of early treatment with rivastigmine in PD patients with minor VH.
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spelling pubmed-84137622021-09-07 Rivastigmine for minor visual hallucinations in Parkinson's disease: A randomized controlled trial with 24 months follow‐up van Mierlo, Tom J. M. Foncke, Elisabeth M. J. Post, Bart Schmand, Ben A. Bloem, Bastiaan R. van Harten, Barbera Tissingh, Gerrit Munts, Alexander G. de Haan, Rob J. de Bie, Rob M. A. Brain Behav Original Research BACKGROUND: Visual hallucinations are common in patients with Parkinson's disease and represent probably the major independent predictor for cognitive deterioration and nursing home placement. OBJECTIVE: To investigate if treatment of minor visual hallucinations in Parkinson's disease with rivastigmine delays the progression to psychosis. METHODS: A multicenter, randomized, double‐blind, placebo‐controlled trial was conducted which aimed to recruit 168 patients with Parkinson's disease reporting minor visual hallucinations 4 weeks before it. Important exclusion criteria were Parkinson's disease dementia, current delirium, and treatment with antipsychotics or drugs that have significant anti‐cholinergic side effects. Subjects were randomized to rivastigmine capsules, 3–6 mg twice a day, or placebo for 24 months. The primary outcome was the time to Parkinson's disease psychosis, which was defined as the need to start with antipsychotics. RESULTS: The trial was stopped prematurely because of slow recruitment. Ninety‐one patients were randomized: 46 patients were assigned to rivastigmine and 45 patients to placebo. No effect of rivastigmine could be demonstrated on the transition time to psychosis or dementia during the 24‐month follow‐up period. After 6 months of study treatment, cognition, mood, motor performance, and non‐motor performance did not differ significantly between the rivastigmine‐group and the placebo‐group. CONCLUSIONS: Because the study was terminated early, it was insufficiently powered to properly evaluate the primary outcome. The limited data of the study favor a wait and see approach instead of early treatment with rivastigmine in PD patients with minor VH. John Wiley and Sons Inc. 2021-07-21 /pmc/articles/PMC8413762/ /pubmed/34291590 http://dx.doi.org/10.1002/brb3.2257 Text en © 2021 The Authors. Brain and Behavior published by Wiley Periodicals LLC https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
van Mierlo, Tom J. M.
Foncke, Elisabeth M. J.
Post, Bart
Schmand, Ben A.
Bloem, Bastiaan R.
van Harten, Barbera
Tissingh, Gerrit
Munts, Alexander G.
de Haan, Rob J.
de Bie, Rob M. A.
Rivastigmine for minor visual hallucinations in Parkinson's disease: A randomized controlled trial with 24 months follow‐up
title Rivastigmine for minor visual hallucinations in Parkinson's disease: A randomized controlled trial with 24 months follow‐up
title_full Rivastigmine for minor visual hallucinations in Parkinson's disease: A randomized controlled trial with 24 months follow‐up
title_fullStr Rivastigmine for minor visual hallucinations in Parkinson's disease: A randomized controlled trial with 24 months follow‐up
title_full_unstemmed Rivastigmine for minor visual hallucinations in Parkinson's disease: A randomized controlled trial with 24 months follow‐up
title_short Rivastigmine for minor visual hallucinations in Parkinson's disease: A randomized controlled trial with 24 months follow‐up
title_sort rivastigmine for minor visual hallucinations in parkinson's disease: a randomized controlled trial with 24 months follow‐up
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8413762/
https://www.ncbi.nlm.nih.gov/pubmed/34291590
http://dx.doi.org/10.1002/brb3.2257
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