Title:Treatment Possibilities for Psychosis in Parkinson's Disease with An Emphasis on the Newly Approved Drug: Pimavanserin
Volume: 16
Issue: 3
Author(s): Zsofia Majlath, Izabella Obal and Laszlo Vecsei*
Affiliation:
- Department of Neurology, University of Szeged, Faculty of Medicine, Albert Szent-Györgyi Clinical Centre, Semmelweis u. 6., H-6725 Szeged,Hungary
Keywords:
Clozapine, Parkinson's disease psychosis, pimavanserin, quetiapine, serotonin 2a receptor inverse agonist.
Abstract: Parkinson’s disease (PD) is a progressive neurodegenerative disorder with prominent motor
and non-motor symptoms. Psychosis develops in over 40% of PD patients and it is one of the most distressing
symptoms for patients and caregivers alike. Until recently, atypical antipsychotics, clozapine
and quetiapine were used to treat psychotic symptoms, but treatment was associated with substantial
concerns for side-effects of clozapine and unfounded efficacy for quetiapine. Extensive research has
shown that the antipsychotic effect of these drugs could be attributed to serotonin 2a receptor (5-HT2A)
triggered mechanisms. A selective 5-HT2A inverse agonist, pimavanserin, has been developed, investigated
and has gained approval in April 2016 in the US for the treatment of hallucinations and delusions
in PD. In this review we primarily focus on psychosis in PD, the current treatment possibilities and the
new, emerging therapy, pimavanserin, a selective 5-HT2A inverse agonist. All articles were reviewed in
this topic and indexed in PubMed with keywords: Parkinson’s disease psychosis, serotonin 2a receptor
inverse agonist, clozapine, quetiapine, pimavanserin.
