Risperidone in the treatment of dopamine-induced psychosis in Parkinson's disease: An open pilot trial
Identifieur interne : 003561 ( Main/Exploration ); précédent : 003560; suivant : 003562Risperidone in the treatment of dopamine-induced psychosis in Parkinson's disease: An open pilot trial
Auteurs : Erich Mohr [Canada] ; Tilak Mendis [Canada] ; Kathleen Hildebrand [Canada] ; Peter Paul De Deyn [Belgique]Source :
- Movement disorders [ 0885-3185 ] ; 2000.
Descripteurs français
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Antiparkinson Agents (adverse effects), Antiparkinson agent, Antipsychotic Agents (therapeutic use), Belgium, Canada, Chemotherapy, Dopamine (adverse effects), Dopamine Antagonists (therapeutic use), Dopamine antagonist, Dopamine receptor, Dose-Response Relationship, Drug, Drug Therapy, Combination, Female, Human, Humans, Levodopa, Male, Middle Aged, Neuroleptic, Parkinson Disease (complications), Parkinson Disease (drug therapy), Parkinson disease, Pilot Projects, Psychiatric Status Rating Scales, Psychoses, Substance-Induced (drug therapy), Psychosis, Psychotropic, Risperidone, Risperidone (therapeutic use), Serotonin antagonist, Serotonine receptor, Short term, Toxicity, Treatment, Treatment Outcome.
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Dopamine.
- chemical , therapeutic use : Antipsychotic Agents, Dopamine Antagonists, Risperidone.
- geographic : Belgium, Canada.
- complications : Parkinson Disease.
- drug therapy : Parkinson Disease, Psychoses, Substance-Induced.
- Adult, Aged, Aged, 80 and over, Dose-Response Relationship, Drug, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Pilot Projects, Psychiatric Status Rating Scales, Treatment Outcome.
Abstract
PURPOSE: To evaluate the safety and efficacy of risperidone in patients with Parkinson's disease (PD) who are experiencing significant dopamine-induced psychosis. PATIENTS AND METHODS: Seventeen patients (median age, 72 yrs) participated in this 12-week, open pilot study receiving 0.5 to 3 mg oral risperidone per day. Maintenance antiparkinsonian medication was continued throughout, although psychotropic medication was discontinued. EFFICACY RESULTS: Risperidone produced a substantial improvement in psychotic symptoms, shown on the mean total positive subscale score on the Positive and Negative Syndrome Scale (PANSS) by a 30% improvement (-3.1 decrease) after 1 week and a 66% improvement (-6.8 decrease) at end point. This improvement was most evident in the items delusions, hallucinatory behavior, and suspiciousness/persecution. Risperidone also achieved significant improvement from baseline in Clinical Global Impression (CGI)-severity and CGI-improvement (p <0.001, Page test). Risperidone treatment did not adversely affect symptoms specific to Parkinson's disease, as assessed by the Unified Parkinson's Disease Rating Scale (UPDRS). SAFETY RESULTS: Sixteen patients reported at least one adverse event, but only two patients withdrew as a result of adverse events. No significant changes or clinically relevant abnormalities were observed in laboratory parameters or vital signs. CONCLUSION: Short-term use of risperidone (mean dosage, 1, 1 mg per day) improves the psychopathology of patients with PD who have dopamine-induced psychosis without adversely affecting the symptoms of PD. Higher doses and long-term use were not addressed in this study and may be precluded by extrapyramidal side effects.
Affiliations:
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xml:lang="en" level="a">Risperidone in the treatment of dopamine-induced psychosis in Parkinson's disease: An open pilot trial</title><author><name sortKey="Mohr, Erich" sort="Mohr, Erich" uniqKey="Mohr E" first="Erich" last="Mohr">Erich Mohr</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>CroMedica Global Inc.</s1><s2>Victoria</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>CroMedica Global Inc.</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>University of Ottawa</s1><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>University of Ottawa</wicri:noRegion></affiliation></author><author><name sortKey="Mendis, Tilak" sort="Mendis, Tilak" uniqKey="Mendis T" first="Tilak" last="Mendis">Tilak Mendis</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Ottawa Civic Hospital and University of Ottawa</s1><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Ottawa Civic Hospital and University of Ottawa</wicri:noRegion></affiliation></author><author><name sortKey="Hildebrand, Kathleen" sort="Hildebrand, Kathleen" uniqKey="Hildebrand K" first="Kathleen" last="Hildebrand">Kathleen Hildebrand</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>CroMedica Global Inc.</s1><s2>Victoria</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>CroMedica Global Inc.</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>University of Ottawa</s1><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>University of Ottawa</wicri:noRegion></affiliation></author><author><name sortKey="De Deyn, Peter Paul" sort="De Deyn, Peter Paul" uniqKey="De Deyn P" first="Peter Paul" last="De Deyn">Peter Paul De Deyn</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Middelheim Hospital, University of Antwerp</s1><s2>Antwerp</s2><s3>BEL</s3><sZ>4 aut.</sZ></inist:fA14><country>Belgique</country><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName><orgName type="university">Université d'Anvers</orgName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2000">2000</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Antiparkinson Agents (adverse effects)</term><term>Antiparkinson agent</term><term>Antipsychotic Agents (therapeutic use)</term><term>Belgium</term><term>Canada</term><term>Chemotherapy</term><term>Dopamine (adverse effects)</term><term>Dopamine Antagonists (therapeutic use)</term><term>Dopamine antagonist</term><term>Dopamine receptor</term><term>Dose-Response Relationship, Drug</term><term>Drug Therapy, Combination</term><term>Female</term><term>Human</term><term>Humans</term><term>Levodopa</term><term>Male</term><term>Middle Aged</term><term>Neuroleptic</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson disease</term><term>Pilot Projects</term><term>Psychiatric Status Rating Scales</term><term>Psychoses, Substance-Induced (drug therapy)</term><term>Psychosis</term><term>Psychotropic</term><term>Risperidone</term><term>Risperidone (therapeutic use)</term><term>Serotonin antagonist</term><term>Serotonine receptor</term><term>Short term</term><term>Toxicity</term><term>Treatment</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Dopamine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antipsychotic Agents</term><term>Dopamine Antagonists</term><term>Risperidone</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Belgium</term><term>Canada</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term><term>Psychoses, Substance-Induced</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Dose-Response Relationship, Drug</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pilot Projects</term><term>Psychiatric Status Rating Scales</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Psychose</term><term>Lévodopa</term><term>Chimiothérapie</term><term>Antiparkinsonien</term><term>Rispéridone</term><term>Neuroleptique</term><term>Psychotrope</term><term>Antagoniste dopamine</term><term>Antagoniste sérotonine</term><term>Récepteur dopaminergique</term><term>Récepteur sérotoninergique</term><term>Traitement</term><term>Toxicité</term><term>Homme</term><term>Court terme</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Belgique</term><term>Canada</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">PURPOSE: To evaluate the safety and efficacy of risperidone in patients with Parkinson's disease (PD) who are experiencing significant dopamine-induced psychosis. PATIENTS AND METHODS: Seventeen patients (median age, 72 yrs) participated in this 12-week, open pilot study receiving 0.5 to 3 mg oral risperidone per day. Maintenance antiparkinsonian medication was continued throughout, although psychotropic medication was discontinued. EFFICACY RESULTS: Risperidone produced a substantial improvement in psychotic symptoms, shown on the mean total positive subscale score on the Positive and Negative Syndrome Scale (PANSS) by a 30% improvement (-3.1 decrease) after 1 week and a 66% improvement (-6.8 decrease) at end point. This improvement was most evident in the items delusions, hallucinatory behavior, and suspiciousness/persecution. Risperidone also achieved significant improvement from baseline in Clinical Global Impression (CGI)-severity and CGI-improvement (p <0.001, Page test). Risperidone treatment did not adversely affect symptoms specific to Parkinson's disease, as assessed by the Unified Parkinson's Disease Rating Scale (UPDRS). SAFETY RESULTS: Sixteen patients reported at least one adverse event, but only two patients withdrew as a result of adverse events. No significant changes or clinically relevant abnormalities were observed in laboratory parameters or vital signs. CONCLUSION: Short-term use of risperidone (mean dosage, 1, 1 mg per day) improves the psychopathology of patients with PD who have dopamine-induced psychosis without adversely affecting the symptoms of PD. Higher doses and long-term use were not addressed in this study and may be precluded by extrapyramidal side effects.</div></front></TEI><affiliations><list><country><li>Belgique</li><li>Canada</li></country><region><li>Province d'Anvers</li><li>Région flamande</li></region><settlement><li>Anvers</li></settlement><orgName><li>Université d'Anvers</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Mohr, Erich" sort="Mohr, Erich" uniqKey="Mohr E" first="Erich" last="Mohr">Erich Mohr</name></noRegion><name sortKey="Hildebrand, Kathleen" sort="Hildebrand, Kathleen" uniqKey="Hildebrand K" first="Kathleen" last="Hildebrand">Kathleen Hildebrand</name><name sortKey="Hildebrand, Kathleen" sort="Hildebrand, Kathleen" uniqKey="Hildebrand K" first="Kathleen" last="Hildebrand">Kathleen Hildebrand</name><name sortKey="Mendis, Tilak" sort="Mendis, Tilak" uniqKey="Mendis T" first="Tilak" last="Mendis">Tilak Mendis</name><name sortKey="Mohr, Erich" sort="Mohr, Erich" uniqKey="Mohr E" first="Erich" last="Mohr">Erich Mohr</name></country><country name="Belgique"><region name="Région flamande"><name sortKey="De Deyn, Peter Paul" sort="De Deyn, Peter Paul" uniqKey="De Deyn P" first="Peter Paul" last="De Deyn">Peter Paul De Deyn</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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