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https://www.readbyqxmd.com/read/28331324/update-on-the-treatment-of-parkinson-s-disease-psychosis-role-of-pimavanserin
#1
REVIEW
Brianna L Combs, Arthur G Cox
Parkinson's disease (PD) has a prevalence of nearly 1 million people in the USA, with increasing incidence in the elderly population. Generally, the age of presentation is between 55 and 65 years, with the likelihood of diagnosis increasing as patients reach the age of 80 years or above. Some of the common treatments for PD increase dopamine levels in the brain. Dopaminergic therapy helps to improve motor and non-motor symptoms, but it is not without risks. Dopaminergic therapy can cause confusion, delirium, and psychotic-like behavior...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28300462/an-update-on-the-advancements-in-the-treatment-of-agitation-in-alzheimer-s-disease
#2
Anton P Porsteinsson, Inga M Antonsdottir
Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are associated with significant negative outcomes for patients and their caregivers. Agitation, one of the most distressing NPS, lacks well-established long term interventions that are both effective and safe. While nonpharmacological interventions are suggested as first-line treatment, they aren't effective in managing symptoms for every patient, resulting in pharmacological interventions for some patients. Traditionally these interventions consist of off-label use of antipsychotics, sedative/hypnotics, anxiolytics, acetylcholinesterase inhibitors, memantine, and antidepressants; where the efficacy doesn't necessarily outweigh the associated risks...
March 16, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28130646/the-effect-of-mirtazapine-on-dopaminergic-psychosis-and-dyskinesia-in-the-parkinsonian-marmoset
#3
Adjia Hamadjida, Stephen G Nuara, Nicolas Veyres, Imane Frouni, Cynthia Kwan, Lamia Sid-Otmane, Mery-Jane Harraka, Jim C Gourdon, Philippe Huot
BACKGROUND: Parkinson's disease (PD) psychosis is encountered in as many as 50% of patients with advanced disease. Treatment options for PD psychosis are few. In fact, only clozapine and pimavanserin have shown efficacy in randomised controlled trials. Clinicians are often reluctant to prescribe the former, due to the risk of agranulocytosis, while the latter is not widely available yet. Because it is already clinically available and exhibits high affinity for serotonin 2A receptors, a target with which both clozapine and pimavanserin interact, we hypothesised that the anti-depressant mirtazapine might be effective to alleviate PD psychosis...
March 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28106066/the-psychosis-spectrum-in-parkinson-disease
#4
REVIEW
Dominic H Ffytche, Byron Creese, Marios Politis, K Ray Chaudhuri, Daniel Weintraub, Clive Ballard, Dag Aarsland
In 2007, the clinical and research profile of illusions, hallucinations, delusions and related symptoms in Parkinson disease (PD) was raised with the publication of a consensus definition of PD psychosis. Symptoms that were previously deemed benign and clinically insignificant were incorporated into a continuum of severity, leading to the rapid expansion of literature focusing on clinical aspects, mechanisms and treatment. Here, we review this literature and the evolving view of PD psychosis. Key topics include the prospective risk of dementia in individuals with PD psychosis, and the causal and modifying effects of PD medication...
February 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27955830/inverse-agonists-what-do-they-mean-for-psychiatry
#5
David Nutt, Stephen Stahl, Pierre Blier, Filippo Drago, Joseph Zohar, Sue Wilson
The nomenclature of drugs is a critical aspect of science, since it can direct research and optimize treatment choices. Traditionally drugs acting on CNS receptors have been classified as either agonists or antagonists. Recently a new class of ligand, the inverse agonist, has been identified in some receptor systems. Inverse agonists have opposite actions to those of agonists but the effects of both of these can be blocked by antagonists. Pimavanserin is a new 5-HT2A receptor acting drug that has been given market authorization for psychosis in Parkinson׳s disease...
January 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27857126/repeated-7-day-treatment-with-the-5-ht2c-agonist-lorcaserin-or-the-5-ht2a-antagonist-pimavanserin-alone-or-in-combination-fails-to-reduce-cocaine-vs-food-choice-in-male-rhesus-monkeys
#6
Matthew L Banks, S Stevens Negus
Cocaine use disorder is a global public health problem for which there are no Food and Drug Administration-approved pharmacotherapies. Emerging preclinical evidence has implicated both serotonin (5-HT) 2C and 2A receptors as potential mechanisms for mediating serotonergic attenuation of cocaine abuse-related neurochemical and behavioral effects. Therefore, the present study aim was to determine whether repeated 7-day treatment with the 5-HT2C agonist lorcaserin (0.1-1.0 mg/kg per day, intramuscular; 0.032-0...
April 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27830568/psychosis-in-parkinson-disease-a-review-of-etiology-phenomenology-and-management
#7
REVIEW
Niyatee Samudra, Neepa Patel, Kyle B Womack, Pravin Khemani, Shilpa Chitnis
Parkinson disease psychosis (PDP) is a common phenomenon in Parkinson disease (PD) patients treated with dopaminergic drugs, and is associated with high morbidity and mortality. It also correlates with depression and dementia, and can contribute to considerable caregiver stress and burnout. While symptoms can be relieved by decreasing doses or number of anti-PD medications, this may lead to an unacceptable worsening of motor function. When general medical or psychiatric conditions have been ruled out, and decreasing dopaminergic agents is not effective in treating psychosis, therapies include atypical antipsychotics, primarily clozapine and quetiapine...
December 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27800022/evidence-for-the-use-of-pimavanserin-in-the-treatment-of-parkinson-s-disease-psychosis
#8
REVIEW
Harini Sarva, Claire Henchcliffe
Parkinson's disease (PD) is a progressive neurodegenerative disorder with both motor and nonmotor symptoms (NMS), leading to significant morbidity and caregiver burden. Psychosis is common but is under recognized by physicians. When present, it increases the patient's risk of hospitalization and nursing home placement and caregiver burden. Although the atypical antipsychotic agent, clozapine, has been considered the gold standard treatment, severe agranulocytosis in 0.38% of patients and more commonly milder leukopenia, resulting in frequent blood testing, limit its use...
November 2016: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/27719624/treatment-possibilities-for-psychosis-in-parkinson-s-disease-with-an-emphasis-on-the-newly-approved-drug-pimavanserin
#9
Zsófia Majláth, Izabella Obál, László Vécsei
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...
October 6, 2016: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/27609312/pimavanserin-for-the-treatment-of-parkinson-s-disease-psychosis
#10
REVIEW
Ines Chendo, Joaquim J Ferreira
INTRODUCTION: Parkinson´s disease (PD) is a synucleinopathy that affects millions of people worldwide and leads to progressive disability. Psychosis is highly prevalent in PD patients and is associated with poor prognosis. Until April 2016, there were no licensed drugs available in the United States of America (USA) for the treatment of PD psychosis (PDP). Pimavanserin is the first Food and Drug Administration approved medicine for the treatment of hallucinations and delusions associated with PDP...
October 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27594111/reslizumab-ixekizumab-and-pimavanserin-tartrate
#11
Daniel A Hussar, Christine A Dimaculangan
No abstract text is available yet for this article.
September 2016: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/27565217/morphine-induced-straub-tail-reaction-in-mice-treated-with-serotonergic-compounds
#12
Irina V Belozertseva, Olga A Dravolina, Margarita A Tur, Marina G Semina, Edwin E Zvartau, Anton Yu Bespalov
Constitutively active 5-HT2 receptors have been suggested to contribute to motoneuronal excitability, muscle spasms and spasticity. Accordingly, 5-HT2C receptor inverse agonists have been demonstrated in pilot experiments to reduce spasticity in animal model of spasticity and patients with spinal cord injuries. Thus, 5-HT2C receptor inverse agonists may represent a novel class of anti-spasticity agents justifying a search for compounds with robust 5-HT2C receptor inverse agonist activity either among the existing medications or via a dedicated drug discovery program...
November 15, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27559192/sugammadex
#13
Dennis J Cada, Terri L Levien, Danial E Baker
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers...
July 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/27504063/pharmaceutical-approval-update
#14
Michele B Kaufman
Venetoclax (Venclexta) for chronic lymphocytic leukemia; riboflavin 5'-phosphate solutions (Photrexa Viscous and Photrexa) for progressive keratoconus; and pimavanserin (Nuplazid) for Parkinson's disease psychosis.
August 2016: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/27504054/the-efficacy-and-safety-of-antipsychotic-medications-in-the-treatment-of-psychosis-in-patients-with-parkinson-s-disease
#15
REVIEW
Nevena Divac, Radan Stojanović, Katarina Savić Vujović, Branislava Medić, Aleksandar Damjanović, Milica Prostran
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...
2016: Behavioural Neurology
https://www.readbyqxmd.com/read/27503570/mechanism-of-action-of-pimavanserin-in-parkinson-s-disease-psychosis-targeting-serotonin-5ht2a-and-5ht2c-receptors
#16
Stephen M Stahl
Pimavanserin, a novel agent approved for the treatment of Parkinson's disease psychosis, has potent actions as an antagonist/inverse agonist at serotonin 5HT2A receptors and less potent antagonist/inverse agonist actions at 5HT2C receptors.
August 2016: CNS Spectrums
https://www.readbyqxmd.com/read/27262680/pimavanserin-first-global-approval
#17
REVIEW
Anthony Markham
Pimavanserin (Nuplazid™) is a selective and potent serotonin 2A (5-HT2A) receptor inverse agonist and antagonist developed by ACADIA Pharmaceuticals that has been approved in the US as a treatment for patients with hallucinations and delusions associated with Parkinson's disease psychosis. Up to 60 % of patients with Parkinson's disease may develop Parkinson's disease psychosis, which is associated with increased morbidity and mortality and has few treatment options. This article summarizes the milestones in the development of pimavanserin leading to this first approval for the treatment of hallucinations and delusions in patients with Parkinson's disease psychosis...
July 2016: Drugs
https://www.readbyqxmd.com/read/27261226/pimavanserin-approved-for-parkinson-s-related-hallucinations-delusions
#18
Kate Traynor
No abstract text is available yet for this article.
June 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27249096/pimavanserin-nuplazid-for-parkinson-s-disease-psychosis
#19
(no author information available yet)
No abstract text is available yet for this article.
June 6, 2016: Medical Letter on Drugs and Therapeutics
https://www.readbyqxmd.com/read/27245248/pimavanserin-an-inverse-agonist-antipsychotic-drug
#20
Robert H Howland
Approximately all clinically useful antipsychotic drugs have known activity as dopamine receptor antagonists, but many of these drugs also are inverse agonists at the serotonin-2A (5HT2A) receptor. Pimavanserin is an inverse agonist at the 5HT2A receptor, with a lower binding affinity at the serotonin-2C receptor and sigma 1 receptor, but no significant binding to dopamine or other receptors. Because of its unique pharmacology, pimavanserin was approved for the treatment of psychosis associated with Parkinson's disease, and it has a low risk for exacerbating motor symptoms compared to standard antipsychotic medications...
June 1, 2016: Journal of Psychosocial Nursing and Mental Health Services
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