Antipsychotic use in older adults with parkinson's disease
Identifieur interne : 002964 ( Main/Merge ); précédent : 002963; suivant : 002965Antipsychotic use in older adults with parkinson's disease
Auteurs : Connie Marras [Canada] ; Alexander Kopp [Canada] ; FENG QIU [Canada] ; Anthony E. Lang [Canada] ; Kathy Sykora [Canada] ; Kenneth I. Shulman [Canada] ; Paula A. Rochon [Canada]Source :
- Movement disorders [ 0885-3185 ] ; 2007.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
The choice of agents to treat psychotic symptoms in Parkinson's disease is important given the potential for antipsychotics to worsen Parkinsonism. The purpose of this study was to estimate the incidence of psychotic symptoms requiring treatment in individuals with Parkinson's disease after starting dopaminergic medications, and to describe the agents being selected as initial antipsychotic therapy. Using the administrative health care databases of Ontario, Canada, individuals 66 years of age or older with Parkinson's disease who were newly treated with dopaminergic agents were identified. Subsequent prescriptions for antipsychotic medications were then identified. A total of 10,347 older adults were newly started on dopaminergic agents between 1998 and 2003. The Kaplan-Meier estimate for the cumulative probability of requiring an antipsychotic at 7 years was 35%; 499 individuals (4.8%; 5.2/100 person-years) were prescribed an antipsychotic within 1 year of starting dopaminergic therapy. The proportion of initial antipsychotic prescriptions for typical antipsychotics decreased from 56% (42 of 75) in 1998 to 9% (8 of 88) in 2002. Antipsychotic use is common in individuals with Parkinsonism newly treated with dopaminergic medication. Typical antipsychotics are still commonly being chosen as first-line agents for older patients, indicating a need for interventions to improve practice.
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Lang</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, University Health Network</s1><s2>Toronto</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Department of Medicine, University of Toronto</s1><s2>Toronto</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Sykora, Kathy" sort="Sykora, Kathy" uniqKey="Sykora K" first="Kathy" last="Sykora">Kathy Sykora</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institute for Clinical Evaluative Sciences</s1><s2>Toronto</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Institute for Clinical Evaluative Sciences</wicri:noRegion></affiliation></author><author><name sortKey="Shulman, Kenneth I" sort="Shulman, Kenneth I" uniqKey="Shulman K" first="Kenneth I." last="Shulman">Kenneth I. Shulman</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Department of Medicine, University of Toronto</s1><s2>Toronto</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Psychiatry, Sunnybrook and Women's College Health Sciences Centre</s1><s2>Toronto</s2><s3>CAN</s3><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A." last="Rochon">Paula A. Rochon</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institute for Clinical Evaluative Sciences</s1><s2>Toronto</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Institute for Clinical Evaluative Sciences</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Department of Medicine, University of Toronto</s1><s2>Toronto</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care</s1><s2>Toronto</s2><s3>CAN</s3><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto</wicri:noRegion></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="2007">2007</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>Antipsychotic</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Psychosis</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Parkinson maladie</term><term>Psychose</term><term>Antipsychotique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The choice of agents to treat psychotic symptoms in Parkinson's disease is important given the potential for antipsychotics to worsen Parkinsonism. The purpose of this study was to estimate the incidence of psychotic symptoms requiring treatment in individuals with Parkinson's disease after starting dopaminergic medications, and to describe the agents being selected as initial antipsychotic therapy. Using the administrative health care databases of Ontario, Canada, individuals 66 years of age or older with Parkinson's disease who were newly treated with dopaminergic agents were identified. Subsequent prescriptions for antipsychotic medications were then identified. A total of 10,347 older adults were newly started on dopaminergic agents between 1998 and 2003. The Kaplan-Meier estimate for the cumulative probability of requiring an antipsychotic at 7 years was 35%; 499 individuals (4.8%; 5.2/100 person-years) were prescribed an antipsychotic within 1 year of starting dopaminergic therapy. The proportion of initial antipsychotic prescriptions for typical antipsychotics decreased from 56% (42 of 75) in 1998 to 9% (8 of 88) in 2002. Antipsychotic use is common in individuals with Parkinsonism newly treated with dopaminergic medication. Typical antipsychotics are still commonly being chosen as first-line agents for older patients, indicating a need for interventions to improve practice.</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"><noRegion><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name></noRegion><name sortKey="Feng Qiu" sort="Feng Qiu" uniqKey="Feng Qiu" last="Feng Qiu">FENG QIU</name><name sortKey="Kopp, Alexander" sort="Kopp, Alexander" uniqKey="Kopp A" first="Alexander" last="Kopp">Alexander Kopp</name><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name><name sortKey="Marras, Connie" sort="Marras, Connie" uniqKey="Marras C" first="Connie" last="Marras">Connie Marras</name><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A." last="Rochon">Paula A. Rochon</name><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A." last="Rochon">Paula A. Rochon</name><name sortKey="Rochon, Paula A" sort="Rochon, Paula A" uniqKey="Rochon P" first="Paula A." last="Rochon">Paula A. Rochon</name><name sortKey="Shulman, Kenneth I" sort="Shulman, Kenneth I" uniqKey="Shulman K" first="Kenneth I." last="Shulman">Kenneth I. Shulman</name><name sortKey="Shulman, Kenneth I" sort="Shulman, Kenneth I" uniqKey="Shulman K" first="Kenneth I." last="Shulman">Kenneth I. Shulman</name><name sortKey="Sykora, Kathy" sort="Sykora, Kathy" uniqKey="Sykora K" first="Kathy" last="Sykora">Kathy Sykora</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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