Pimavanserin for Psychotic Symptoms in People With Parkinsonism: A Second Chart Review

Clinical Neuropharmacology
Joseph H Friedman

Abstract

Pimavanserin (Pim) is a 5HT2A inverse agonist that is the only Food and Drug Administration-approved treatment for Parkinson disease (PD) psychosis. The published open-label experience is limited. This report is a chart review of all patients who were started on the drugs since the one earlier report on 15 patients. All patients were included, whether or not they completed 6 weeks of treatment, the time required for maximum benefit found in the published phase 3 trial. Twenty-six patients are reported. Three patients had dementia with Lewy bodies; one had an atypical parkinsonism; 22 had PD, including one with schizophrenia and neuroleptic exacerbated, dopamine transporter scan-positive idiopathic PD; and another had PD complicated by strokes. Six stopped before 6 weeks due to adverse effects, including 1 with worsened psychosis. Eighteen completed at least 6 weeks of treatment. Of these, 3 stopped due to lack of efficacy and 3 due to worsened psychosis. Twelve found it helpful. Of the 18 who took Pim for at least 6 weeks, 12 improved and continue to take it. Almost 50% of parkinsonian patients with psychotic symptoms found Pim to be a useful medication, which they continue to take. Reasons for intolerance varied and were thoug...Continue Reading

References

Mar 11, 1999·The New England Journal of Medicine·UNKNOWN Parkinson Study Group
Feb 7, 2009·Parkinsonism & Related Disorders·C L DotchinR W Walker
Sep 11, 2013·Expert Opinion on Pharmacotherapy·Joseph H Friedman
Apr 16, 2017·Neurologic Clinics·Douglas Galasko
Jun 18, 2017·Clinical Neuropharmacology·Joseph H Friedman
Aug 15, 2017·International Review of Neurobiology·Dominic H Ffytche, Dag Aarsland

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Citations

Jun 2, 2020·Parkinsonism & Related Disorders·Kevin Kyle, Jeff M Bronstein
Apr 16, 2021·Journal of Clinical Psychopharmacology·Jean-Pierre Lindenmayer, Sukaina Rizvi

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