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https://www.readbyqxmd.com/read/29160144/parkinson-s-disease-psychosis-presentation-diagnosis-and-management
#1
Ruth B Schneider, Julia Iourinets, Irene H Richard
Parkinson's disease is a neurodegenerative disorder characterized by motor and nonmotor symptoms. Psychosis is a common feature of Parkinson's disease. Parkinson's disease psychosis (PDP) encompasses minor phenomena (illusions, passage hallucinations and presence hallucinations), visual and nonvisual hallucinations and delusions. PDP is associated with reduced function and quality of life. The initial management approach should focus on identification and treatment of any contributory medical factors, reduction or discontinuation of medications with potential to induce or worsen psychosis, nonpharmacological strategies and consideration of acetylcholinesterase inhibitor treatment in the setting of dementia...
November 21, 2017: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/29105858/investigation-of-metabolic-profile-of-pimavanserin-in-rats-by-uhplc-combined-with-fourier-transform-ion-cyclotron-resonance-mass-spectrometry
#2
Wenying Wu, Yanjie Chu, Shixiao Wang, Xiaoyang Sun, Jingjing Zhang, Yannian Wang, Xiaohui Chen
RATIONALE: Pimavanserin, a selective serotonin 2A receptor inverse agonist, is a promising candidate for treating Parkinson's disease psychosis. Our previous study exhibited that there might be an existence of extensive metabolites of pimavanserin in rats. However, the metabolic fate of pimavanserin in vivo remains unknown. Thus, it is essential to develop an efficient method to investigate metabolic profile of pimavanserin in rats. Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR-MS) to date has the highest mass measurement accuracy and resolution of any mass spectrometry platforms...
November 6, 2017: Rapid Communications in Mass Spectrometry: RCM
https://www.readbyqxmd.com/read/29098976/pimavanserin-for-the-treatment-of-parkinson-s-disease-psychosis-number-needed-to-treat-number-needed-to-harm-and-likelihood-to-be-helped-or-harmed
#3
Leslie Citrome, James C Norton, Kathy Chi-Burris, George Demos
OBJECTIVE: Our aim was to describe the efficacy and tolerability of pimavanserin, a highly selective serotonin 5-HT2A receptor inverse agonist/antagonist indicated for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis (PDP), using the metrics of number needed to treat (NNT) and number needed to harm (NNH). METHODS: Categorical efficacy and tolerability data were extracted from the clinical trial databases of the double-blind placebo-controlled studies of pimavanserin in persons with PDP...
November 3, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/29047301/pimavanserin-novel-pharmacotherapy-for-parkinson-s-disease-psychosis
#4
Zeyad T Sahli, Frank I Tarazi
Pimavanserin is the first FDA-approved atypical antipsychotic drug indicated for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis (PDP). Areas covered: This review focuses on the preclinical discovery of pimavanserin. It analyzes the pharmacological, behavioral and molecular mechanisms of pimavanserin and their contribution to the therapeutic advantages of the drug as reported in published preclinical and clinical studies, and product labels. Expert opinion: Pimavanserin exhibits a unique pharmacological profile with nanomolar affinity at serotonin 5-HT2A and 5-HT2C receptors...
October 19, 2017: Expert Opinion on Drug Discovery
https://www.readbyqxmd.com/read/28880354/-pimavanserin-a-new-treatment-for-the-parkinson-s-disease-psychosis
#5
J H Duits, M S Ongering, H J M Martens, P F J Schulte
Clozapine is an effective drug for treating psychosis in Parkinson's disease (PDP) and is registered as such in the Netherlands. However, clozapine can have adverse effects, including agranulocytosis. The new drug pimavanserin was recently registered in the United States for the treatment of PDP.<br/> AIM: To review the literature on pimavanserin and discuss the position it currently occupies in the Netherlands as a potential treatment for PDP.<br/> METHOD: Systematic search of the literature.<br/> RESULTS: We found reports on four randomised controlled trials (RCTs), one review and six articles about the pharmacokinetics and pharmacodynamics of pimavanserin...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28817967/pimavanserin-a-novel-antipsychotic-for-management-of-parkinson-s-disease-psychosis
#6
REVIEW
Yasaman Kianirad, Tanya Simuni
Parkinson's disease psychosis (PDP) may develop in up to 60% of Parkinson's patients and is associated with increased morbidity and mortality. It also correlates with depression and dementia, and can contribute to caregiver stress and burnout. Pimavanserin is the first FDA approved drug for the treatment of hallucinations and delusions associated with PDP. Areas covered: For this review, a MEDLINE literature search (via PubMed) and information provided by ACADIA Pharmaceuticals were used. This review will discuss the pathophysiology and current management of PDP...
November 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28802934/psychosis-in-parkinson-s-disease
#7
Dominic H Ffytche, Dag Aarsland
Although illusions, hallucinations and delusions did not play a prominent role in James Parkinson's original clinical descriptions, the longitudinal view of disease progression he advocated has important lessons for the study of such symptoms today. A focus on longitudinal progression rather than individual symptoms led to the concept of PD psychosis-a spectrum of positive symptoms in Parkinson's disease. The publication of criteria for PD psychosis in 2007 helped unify the disparate set of symptoms, raising their profile and resulting in a rapid expansion of literature focussing on clinical aspects, mechanisms, and treatment...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28741230/new-therapeutic-strategies-for-lewy-body-dementias
#8
REVIEW
Latha Velayudhan, Dominic Ffytche, Clive Ballard, Dag Aarsland
This article reviews current treatment strategies and recent advances for the Lewy body dementias (LBDs). Current available symptom treatment strategies are based on monoaminergic, cholinergic and glutaminergic neurotransmitter systems. Relatively robust evidence exists for cholinesterase inhibitors for cognitive impairment in LBD and in Parkinson's disease for antidepressants, clozapine and recently pimavanserin for psychosis. interpidine (RVT 101) and nelotanserin are currently under investigation. Non-pharmacological interventions, such as cognitive stimulation, physical exercises and neuromodulation strategies, may be useful in Parkinson's disease but have not yet been tested in dementias...
September 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28715903/parkinson-s-disease-and-parkinson-s-disease-psychosis-a-perspective-on-the-challenges-treatments-and-economic-burden
#9
Doral Fredericks, James C Norton, Carolyn Atchison, Robert Schoenhaus, Michael W Pill
Parkinson's disease (PD) is a progressive neurodegenerative disease associated with a decrease in the neurotransmitter dopamine and characterized by the cardinal motor hallmarks of resting tremor, rigidity, bradykinesia/akinesia, and postural instability. Lesser-known features of PD revolve around nonmotor concerns including psychosis, dementia, sleep disturbances, autonomic dysfunction, and sensory abnormalities. Parkinson's disease psychosis (PDP) contributes significantly to morbidity, mortality, nursing home placement, and quality of life (QOL)...
April 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28638698/atypical-antipsychotic-therapy-in-parkinson-s-disease-psychosis-a-retrospective-study
#10
Mei Yuan, Laura Sperry, Norika Malhado-Chang, Alexandra Duffy, Vicki Wheelock, Sarah Farias, Kevin O'Connor, John Olichney, Kiarash Shahlaie, Lin Zhang
OBJECTIVE: Parkinson's disease psychosis (PDP) is a frequent complication of idiopathic Parkinson's disease (iPD) with significant impact on quality of life and association with poorer outcomes. Atypical antipsychotic drugs (APDs) are often used for the treatment of PDP; however, their use is often complicated by adverse drug reactions (ADRs). In this study, we present patients with PDP who were treated with the most commonly used atypical antipsychotic agents and review their respective ADRs...
June 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28636480/the-emerging-role-of-pimavanserin-in-the-management-of-parkinson-s-disease-psychosis
#11
Neal Hermanowicz, Gustavo Alva, Fernando Pagan, Alberto J Espay, Amita Patel, Katya Cruz Madrid, Daniel Kremens, Jim Kenney, Sheila Arquette, Gary Tereso, Maria Lopes, Carolyn Farnum
A panel of experts drawn from neurology, psychiatry, geropsychiatry, geriatrics, and pharmacy representatives of 3 health plans convened in New York City on July 30, 2016, with the objective of sharing opinions, ideas, and information regarding the optimal management of Parkinson's disease psychosis (PDP). Three key points emerged from the discussion: (1) Because of the nature of Parkinson's disease and PDP, finding appropriate treatment can prove challenging; (2) emerging therapies may present an opportunity for effective disease management; and (3) moving forward, provider and patient education regarding PDP and available treatment options is essential for well-managed symptoms and better quality of life...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28622212/a-retrospective-study-of-pimavanserin-use-in-a-movement-disorders-clinic
#12
Joseph H Friedman
Pimavanserin, a 5-HT2A inverse agonist, was commercially released in the United States in April 2016 for the treatment of Parkinson disease psychosis. No "naturalistic" treatment results have yet been published. Charts from the movement disorders clinic were reviewed for all patients who received this drug as treatment for psychosis associated with primary parkinsonism due to α-synucleinopathies. Data of 10 patients with idiopathic Parkinson disease, including 1 with a long history of schizophrenia, 4 with dementia with Lewy bodies, and 1 with multiple-system atrophy, were reviewed...
July 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28579723/pimavanserin-nuplazid-a-treatment-for-hallucinations-and-delusions-associated-with-parkinson-s-disease
#13
Martin Paspe Cruz
Pimavanserin (Nuplazid) for the treatment of hallucinations and delusions associated with Parkinson's disease.
June 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/28534003/new-pharmacological-approaches-to-treating-non-motor-symptoms-of-parkinson-s-disease
#14
Michael A Kelberman, Elena M Vazey
PURPOSE OF REVIEW: Non-motor symptoms in patients with Parkinson's Disease (PD) are better predictors of quality of life changes, caregiver burden, and mortality than motor symptoms. Levodopa has limited, and sometimes detrimental, effects on these symptoms. In this review we discuss recent evidence on pharmacological treatments for non-motor symptoms. RECENT FINDINGS: Breakthroughs have been made in the treatment of psychosis and sleep dysfunction. Pimavanserin has become the first FDA approved drug for PD psychosis...
December 2016: Current Pharmacology Reports
https://www.readbyqxmd.com/read/28493654/the-us-food-and-drug-administration-s-perspective-on-the-new-antipsychotic-pimavanserin
#15
REVIEW
Mitchell V Mathis, Brendan M Muoio, Paul Andreason, Amy M Avila, Tiffany Farchione, Aisar Atrakchi, Robert J Temple
OBJECTIVE: To summarize the US Food and Drug Administration's (FDA's) review of the safety and effectiveness for pimavanserin, an atypical antipsychotic, for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis. We describe the regulatory and clinical issues important to the FDA's approval of this New Drug Application, with special focus on the risk-benefit balance. We also describe a new labeling feature that presents additional efficacy data to clinicians...
June 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28460160/serotonergic-approaches-in-parkinson-s-disease-translational-perspectives-an-update
#16
Philippe Huot, Véronique Sgambato-Faure, Susan H Fox, Andrew C McCreary
Parkinson's disease (PD) has long been seen as a disorder caused by degeneration of the dopaminergic system, leading to the classic motor manifestations of the disease. However, there is now overwhelming evidence that PD is more than a disease merely caused by dopamine depletion. It is well-known that a myriad of other neurotransmitters are affected by the disease process. One such neurotransmitter is serotonin (5-HT). 5-HT has been shown to play a role in several motor and nonmotor manifestations of PD, including tremor, cognition, depression and psychosis...
May 17, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/28385039/evidence-based-review-of-pharmacotherapy-used-for-parkinson-s-disease-psychosis
#17
REVIEW
Kyle John Wilby, Eric G Johnson, Hannah E Johnson, Mary H H Ensom
OBJECTIVE: To summarize and evaluate the existing literature regarding medications to treat Parkinson's disease (PD) psychosis. DATA SOURCES: MEDLINE (1946 to March 2017), EMBASE (1980 to March 2017), CINAHL (1982 to March 2017), and PsychInfo (1887 to March 2017) were searched using the following terms: Parkinson disease, Parkinson's disease, psychotic disorders, psychosis, delusions, and hallucinations. STUDY SELECTION AND DATA EXTRACTION: The search was limited to randomized controlled trials (RCTs) reporting human outcomes...
August 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28375643/pimavanserin-a-novel-antipsychotic-for-parkinson-s-disease-psychosis
#18
REVIEW
Kevin M Bozymski, Denise K Lowe, Kiersten M Pasternak, Travis L Gatesman, Ericka L Crouse
OBJECTIVE: To review the pharmacology, pharmacokinetics, efficacy, safety, and place in therapy of pimavanserin for the treatment of hallucinations and delusions of Parkinson's disease psychosis (PDP). DATA SOURCES: A comprehensive PubMed search (1966 to January 2017) was conducted using the search terms Parkinson's disease psychosis, hallucinations, delusions, pimavanserin, and ACP-103. Additional data were obtained from references of identified articles, governmental sources, manufacturer product labeling and website, and Clinicaltrials...
June 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28331324/update-on-the-treatment-of-parkinson-s-disease-psychosis-role-of-pimavanserin
#19
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
#20
REVIEW
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 safe and effective long term interventions. Nonpharmacological interventions are suggested as first-line treatment, but aren't effective for every patient, resulting in pharmacological interventions for some patients, consisting of off-label use of antipsychotics, sedative/hypnotics, anxiolytics, acetylcholinesterase inhibitors, memantine, and antidepressants; where efficacy doesn't necessarily outweigh associated risks...
April 2017: Expert Opinion on Pharmacotherapy
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