Olanzapine treatment for dopaminergic-induced hallucinations.
Identifieur interne : 000904 ( Ncbi/Curation ); précédent : 000903; suivant : 000905Olanzapine treatment for dopaminergic-induced hallucinations.
Auteurs : William G. Ondo [États-Unis] ; Joel K. Levy ; Kevin Dat Vuong ; Christine Hunter ; Joseph Jankovic [États-Unis]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2002.
English descriptors
- KwdEn :
- Aged, Antipsychotic Agents (therapeutic use), Benzodiazepines, Cognition Disorders (chemically induced), Cognition Disorders (diagnosis), Dopamine Agonists (adverse effects), Dopamine Agonists (therapeutic use), Double-Blind Method, Female, Hallucinations (chemically induced), Hallucinations (diagnosis), Hallucinations (drug therapy), Humans, Interview, Psychological, Male, Neuropsychological Tests, Parkinson Disease (drug therapy), Pirenzepine (analogs & derivatives), Pirenzepine (therapeutic use).
- MESH :
- chemical , adverse effects : Dopamine Agonists.
- chemical , analogs & derivatives : Pirenzepine.
- chemical , therapeutic use : Antipsychotic Agents, Dopamine Agonists, Pirenzepine.
- chemically induced : Cognition Disorders, Hallucinations.
- diagnosis : Cognition Disorders, Hallucinations.
- drug therapy : Hallucinations, Parkinson Disease.
- Aged, Benzodiazepines, Double-Blind Method, Female, Humans, Interview, Psychological, Male, Neuropsychological Tests.
Abstract
Atypical antipsychotic medications with lower affinities for D2 receptors are considered useful alternatives to treat drug-induced hallucinations in Parkinson's disease (PD). We conducted a double-blind, placebo-controlled, unforced titration, parallel design study (2:1 drug to placebo randomization ratio) using olanzapine (2.5-10 mg/day to effect) in 30 PD patients with drug-induced hallucinations. We performed an extensive battery of neuropsychological tests, the Unified Parkinson's Disease Rating Scale (UPDRS), assessments of on and off time at baseline and at 9 weeks after starting the medication. Sixteen patients on olanzapine (mean dose, 4.6 mg/night) and 11 on placebo completed the study. Compared with placebo, performance on the UPDRS item 2 (thought disorder), and a structured interview for hallucinations, both tended to improve on drug but neither reached statistical significance. A neuropsychological test battery did not show any significant differences. Total on UPDRS motor scores (P < 0.05) and timed tapping (P < 0.01) worsened while on drug compared to placebo. Bradykinesia (P < 0.01) and gait (P < 0.001) items on the UPDRS largely accounted for this deterioration. After completion of the study, 8 of 16 patients randomly assigned to drug continued olanzapine at a mean dose of 2.4 mg/day. However, at the last recorded visit only 5 of 24 (20.8%) of all patients exposed to drug (including those originally randomly assigned to placebo) remained on olanzapine. In patients with PD, low-dose olanzapine did not significantly improve hallucinations but did worsen motor function.
DOI: 10.1002/mds.10217
PubMed: 12360554
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pubmed:12360554Le document en format XML
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<front><div type="abstract" xml:lang="en">Atypical antipsychotic medications with lower affinities for D2 receptors are considered useful alternatives to treat drug-induced hallucinations in Parkinson's disease (PD). We conducted a double-blind, placebo-controlled, unforced titration, parallel design study (2:1 drug to placebo randomization ratio) using olanzapine (2.5-10 mg/day to effect) in 30 PD patients with drug-induced hallucinations. We performed an extensive battery of neuropsychological tests, the Unified Parkinson's Disease Rating Scale (UPDRS), assessments of on and off time at baseline and at 9 weeks after starting the medication. Sixteen patients on olanzapine (mean dose, 4.6 mg/night) and 11 on placebo completed the study. Compared with placebo, performance on the UPDRS item 2 (thought disorder), and a structured interview for hallucinations, both tended to improve on drug but neither reached statistical significance. A neuropsychological test battery did not show any significant differences. Total on UPDRS motor scores (P < 0.05) and timed tapping (P < 0.01) worsened while on drug compared to placebo. Bradykinesia (P < 0.01) and gait (P < 0.001) items on the UPDRS largely accounted for this deterioration. After completion of the study, 8 of 16 patients randomly assigned to drug continued olanzapine at a mean dose of 2.4 mg/day. However, at the last recorded visit only 5 of 24 (20.8%) of all patients exposed to drug (including those originally randomly assigned to placebo) remained on olanzapine. In patients with PD, low-dose olanzapine did not significantly improve hallucinations but did worsen motor function.</div>
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