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Pimavanserin and Parkinson’s Disease Psychosis: A Narrative Review

Pimavanserin (PMV) is the first approved drug for treating hallucinations and delusions in Parkinson’s disease (PD) psychosis. Psychosis is one of the leading causes of nursing home placement in people with PD. Furthermore, hallucinations are a more frequent cause of institutionalization than motor...

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Autores principales: Rissardo, Jamir Pitton, Durante, Ícaro, Sharon, Idan, Fornari Caprara, Ana Letícia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9599742/
https://www.ncbi.nlm.nih.gov/pubmed/36291220
http://dx.doi.org/10.3390/brainsci12101286
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author Rissardo, Jamir Pitton
Durante, Ícaro
Sharon, Idan
Fornari Caprara, Ana Letícia
author_facet Rissardo, Jamir Pitton
Durante, Ícaro
Sharon, Idan
Fornari Caprara, Ana Letícia
author_sort Rissardo, Jamir Pitton
collection PubMed
description Pimavanserin (PMV) is the first approved drug for treating hallucinations and delusions in Parkinson’s disease (PD) psychosis. Psychosis is one of the leading causes of nursing home placement in people with PD. Furthermore, hallucinations are a more frequent cause of institutionalization than motor disability or dementia related to PD. The management of PD psychosis involves antipsychotic medications. Most of the drugs in this class directly block dopamine D2 receptors, leading to significantly worsening motor symptoms in patients with PD. The most commonly used medications for managing PD psychosis are quetiapine, clozapine, and PMV. This literature review aims to study pimavanserin’s history, mechanism, clinical trials, and post-marketing experience. PMV is a potent 5-HT2A receptor antagonist/inverse agonist. Moreover, this drug can interact with 5-HT2C receptors. We calculated some physicochemical descriptors and pharmacokinetic properties of PMV. Eight clinical trials of PMV and PD psychosis are registered on ClinicalTrials.gov. Only four of them have complete results already published. Meta-analytic results showed that PMV efficacy is inferior to clozapine. However, PMV has a significantly lower number of side-effects for managing psychosis in PD. Medicare database assessment revealed 35% lower mortality with PMV compared to other atypical antipsychotics. Moreover, sensitive statistical analysis demonstrated that PMV is a protective factor for the risk of falls in individuals with PD.
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spelling pubmed-95997422022-10-27 Pimavanserin and Parkinson’s Disease Psychosis: A Narrative Review Rissardo, Jamir Pitton Durante, Ícaro Sharon, Idan Fornari Caprara, Ana Letícia Brain Sci Review Pimavanserin (PMV) is the first approved drug for treating hallucinations and delusions in Parkinson’s disease (PD) psychosis. Psychosis is one of the leading causes of nursing home placement in people with PD. Furthermore, hallucinations are a more frequent cause of institutionalization than motor disability or dementia related to PD. The management of PD psychosis involves antipsychotic medications. Most of the drugs in this class directly block dopamine D2 receptors, leading to significantly worsening motor symptoms in patients with PD. The most commonly used medications for managing PD psychosis are quetiapine, clozapine, and PMV. This literature review aims to study pimavanserin’s history, mechanism, clinical trials, and post-marketing experience. PMV is a potent 5-HT2A receptor antagonist/inverse agonist. Moreover, this drug can interact with 5-HT2C receptors. We calculated some physicochemical descriptors and pharmacokinetic properties of PMV. Eight clinical trials of PMV and PD psychosis are registered on ClinicalTrials.gov. Only four of them have complete results already published. Meta-analytic results showed that PMV efficacy is inferior to clozapine. However, PMV has a significantly lower number of side-effects for managing psychosis in PD. Medicare database assessment revealed 35% lower mortality with PMV compared to other atypical antipsychotics. Moreover, sensitive statistical analysis demonstrated that PMV is a protective factor for the risk of falls in individuals with PD. MDPI 2022-09-23 /pmc/articles/PMC9599742/ /pubmed/36291220 http://dx.doi.org/10.3390/brainsci12101286 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Rissardo, Jamir Pitton
Durante, Ícaro
Sharon, Idan
Fornari Caprara, Ana Letícia
Pimavanserin and Parkinson’s Disease Psychosis: A Narrative Review
title Pimavanserin and Parkinson’s Disease Psychosis: A Narrative Review
title_full Pimavanserin and Parkinson’s Disease Psychosis: A Narrative Review
title_fullStr Pimavanserin and Parkinson’s Disease Psychosis: A Narrative Review
title_full_unstemmed Pimavanserin and Parkinson’s Disease Psychosis: A Narrative Review
title_short Pimavanserin and Parkinson’s Disease Psychosis: A Narrative Review
title_sort pimavanserin and parkinson’s disease psychosis: a narrative review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9599742/
https://www.ncbi.nlm.nih.gov/pubmed/36291220
http://dx.doi.org/10.3390/brainsci12101286
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