Psychosis in Parkinson's Disease: Epidemiology, Pathophysiology, and Management.
Identifieur interne : 000224 ( Main/Exploration ); précédent : 000223; suivant : 000225Psychosis in Parkinson's Disease: Epidemiology, Pathophysiology, and Management.
Auteurs : Anna Chang [Canada] ; Susan H. Fox [Canada]Source :
- Drugs [ 1179-1950 ] ; 2016.
English descriptors
- KwdEn :
- Brain (physiopathology), Disease Management, Humans, Parkinson Disease (complications), Parkinson Disease (drug therapy), Parkinson Disease (psychology), Psychotic Disorders (complications), Psychotic Disorders (drug therapy), Psychotic Disorders (epidemiology), Psychotic Disorders (physiopathology), Risk Factors.
- MESH :
- complications : Parkinson Disease, Psychotic Disorders.
- drug therapy : Parkinson Disease, Psychotic Disorders.
- epidemiology : Psychotic Disorders.
- physiopathology : Brain, Psychotic Disorders.
- psychology : Parkinson Disease.
- Disease Management, Humans, Risk Factors.
Abstract
Psychotic symptoms are common in Parkinson's disease (PD) and are associated with poorer quality of life and increased caregiver burden. PD psychosis is correlated with several factors, such as more advanced disease, cognitive impairment, depression, and sleep disorders. The underlying causes of psychosis in PD thus involve a complex interplay between exogenous (e.g., drugs, intercurrent illnesses) and endogenous (e.g., PD disease pathology) factors. Current theories of the pathophysiology of PD psychosis have come from several neuropathological and neuroimaging studies that implicate pathways involving visual processing and executive function, including temporo-limbic structures and neocortical gray matter with altered neurotransmitter functioning (e.g., dopamine, serotonin, and acetylcholine). Treatment of PD psychosis requires a step-wise process, including initial careful investigation of treatable triggering conditions and a comprehensive evaluation with adjustment of PD medications and/or initiation of specific antipsychotic therapies. Clozapine remains the only recommended drug for the treatment of PD psychosis; however, because of regular blood monitoring, quetiapine is usually first-line therapy, although less efficacious. Emerging studies have focused on agents involving other neurotransmitters, including the serotonin 5-HT2A receptor inverse agonist pimavanserin, cholinesterase inhibitors, and antidepressants and anxiolytics.
DOI: 10.1007/s40265-016-0600-5
PubMed: 27312429
Affiliations:
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Le document en format XML
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Fox</name><affiliation wicri:level="4"><nlm:affiliation>Morton and Gloria Shulman Movement Disorder Clinic, University of Toronto, Toronto Western Hospital, 7th Floor, McLaughlin Pavilion, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada. sfox@uhnresearch.ca.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Morton and Gloria Shulman Movement Disorder Clinic, University of Toronto, Toronto Western Hospital, 7th Floor, McLaughlin Pavilion, 399 Bathurst Street, Toronto, ON, M5T 2S8</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j">Drugs</title><idno type="eISSN">1179-1950</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Brain (physiopathology)</term><term>Disease Management</term><term>Humans</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (psychology)</term><term>Psychotic Disorders (complications)</term><term>Psychotic Disorders (drug therapy)</term><term>Psychotic Disorders (epidemiology)</term><term>Psychotic Disorders (physiopathology)</term><term>Risk Factors</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term><term>Psychotic Disorders</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term><term>Psychotic Disorders</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Psychotic Disorders</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Brain</term><term>Psychotic Disorders</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Disease Management</term><term>Humans</term><term>Risk Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Psychotic symptoms are common in Parkinson's disease (PD) and are associated with poorer quality of life and increased caregiver burden. PD psychosis is correlated with several factors, such as more advanced disease, cognitive impairment, depression, and sleep disorders. The underlying causes of psychosis in PD thus involve a complex interplay between exogenous (e.g., drugs, intercurrent illnesses) and endogenous (e.g., PD disease pathology) factors. Current theories of the pathophysiology of PD psychosis have come from several neuropathological and neuroimaging studies that implicate pathways involving visual processing and executive function, including temporo-limbic structures and neocortical gray matter with altered neurotransmitter functioning (e.g., dopamine, serotonin, and acetylcholine). Treatment of PD psychosis requires a step-wise process, including initial careful investigation of treatable triggering conditions and a comprehensive evaluation with adjustment of PD medications and/or initiation of specific antipsychotic therapies. Clozapine remains the only recommended drug for the treatment of PD psychosis; however, because of regular blood monitoring, quetiapine is usually first-line therapy, although less efficacious. Emerging studies have focused on agents involving other neurotransmitters, including the serotonin 5-HT2A receptor inverse agonist pimavanserin, cholinesterase inhibitors, and antidepressants and anxiolytics.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Chang, Anna" sort="Chang, Anna" uniqKey="Chang A" first="Anna" last="Chang">Anna Chang</name></region><name sortKey="Fox, Susan H" sort="Fox, Susan H" uniqKey="Fox S" first="Susan H" last="Fox">Susan H. Fox</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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