Olanzapine treatment for dopaminergic-induced hallucinations.
Identifieur interne : 003947 ( PubMed/Curation ); précédent : 003946; suivant : 003948Olanzapine treatment for dopaminergic-induced hallucinations.
Auteurs : William G. Ondo [États-Unis] ; Joel K. Levy ; Kevin Dat Vuong ; Christine Hunter ; Joseph JankovicSource :
- 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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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Olanzapine treatment for dopaminergic-induced hallucinations.</title><author><name sortKey="Ondo, William G" sort="Ondo, William G" uniqKey="Ondo W" first="William G" last="Ondo">William G. Ondo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Baylor College of Medicine, Houston, Texas, USA. wondo@bcm.tcm.edu</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, Baylor College of Medicine, Houston, Texas</wicri:regionArea></affiliation></author><author><name sortKey="Levy, Joel K" sort="Levy, Joel K" uniqKey="Levy J" first="Joel K" last="Levy">Joel K. Levy</name></author><author><name sortKey="Vuong, Kevin Dat" sort="Vuong, Kevin Dat" uniqKey="Vuong K" first="Kevin Dat" last="Vuong">Kevin Dat Vuong</name></author><author><name sortKey="Hunter, Christine" sort="Hunter, Christine" uniqKey="Hunter C" first="Christine" last="Hunter">Christine Hunter</name></author><author><name sortKey="Jankovic, Joseph" sort="Jankovic, Joseph" uniqKey="Jankovic J" first="Joseph" last="Jankovic">Joseph Jankovic</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2002">2002</date><idno type="RBID">pubmed:12360554</idno><idno type="pmid">12360554</idno><idno type="doi">10.1002/mds.10217</idno><idno type="wicri:Area/PubMed/Corpus">003947</idno><idno type="wicri:Area/PubMed/Curation">003947</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Olanzapine treatment for dopaminergic-induced hallucinations.</title><author><name sortKey="Ondo, William G" sort="Ondo, William G" uniqKey="Ondo W" first="William G" last="Ondo">William G. Ondo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Baylor College of Medicine, Houston, Texas, USA. wondo@bcm.tcm.edu</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, Baylor College of Medicine, Houston, Texas</wicri:regionArea></affiliation></author><author><name sortKey="Levy, Joel K" sort="Levy, Joel K" uniqKey="Levy J" first="Joel K" last="Levy">Joel K. Levy</name></author><author><name sortKey="Vuong, Kevin Dat" sort="Vuong, Kevin Dat" uniqKey="Vuong K" first="Kevin Dat" last="Vuong">Kevin Dat Vuong</name></author><author><name sortKey="Hunter, Christine" sort="Hunter, Christine" uniqKey="Hunter C" first="Christine" last="Hunter">Christine Hunter</name></author><author><name sortKey="Jankovic, Joseph" sort="Jankovic, Joseph" uniqKey="Jankovic J" first="Joseph" last="Jankovic">Joseph Jankovic</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antipsychotic Agents (therapeutic use)</term><term>Benzodiazepines</term><term>Cognition Disorders (chemically induced)</term><term>Cognition Disorders (diagnosis)</term><term>Dopamine Agonists (adverse effects)</term><term>Dopamine Agonists (therapeutic use)</term><term>Double-Blind Method</term><term>Female</term><term>Hallucinations (chemically induced)</term><term>Hallucinations (diagnosis)</term><term>Hallucinations (drug therapy)</term><term>Humans</term><term>Interview, Psychological</term><term>Male</term><term>Neuropsychological Tests</term><term>Parkinson Disease (drug therapy)</term><term>Pirenzepine (analogs & derivatives)</term><term>Pirenzepine (therapeutic use)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Dopamine Agonists</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analogs & derivatives" xml:lang="en"><term>Pirenzepine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antipsychotic Agents</term><term>Dopamine Agonists</term><term>Pirenzepine</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Cognition Disorders</term><term>Hallucinations</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Cognition Disorders</term><term>Hallucinations</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Hallucinations</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Benzodiazepines</term><term>Double-Blind Method</term><term>Female</term><term>Humans</term><term>Interview, Psychological</term><term>Male</term><term>Neuropsychological Tests</term></keywords></textClass></profileDesc></teiHeader><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></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">12360554</PMID><DateCreated><Year>2002</Year><Month>10</Month><Day>02</Day></DateCreated><DateCompleted><Year>2003</Year><Month>01</Month><Day>08</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>17</Volume><Issue>5</Issue><PubDate><Year>2002</Year><Month>Sep</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Olanzapine treatment for dopaminergic-induced hallucinations.</ArticleTitle><Pagination><MedlinePgn>1031-5</MedlinePgn></Pagination><Abstract><AbstractText>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. 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UI="D001569">Benzodiazepines</NameOfSubstance></Chemical><Chemical><RegistryNumber>132539-06-1</RegistryNumber><NameOfSubstance UI="C076029">olanzapine</NameOfSubstance></Chemical><Chemical><RegistryNumber>3G0285N20N</RegistryNumber><NameOfSubstance UI="D010890">Pirenzepine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D014150">Antipsychotic Agents</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000627">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D001569">Benzodiazepines</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D003072">Cognition Disorders</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000139">chemically induced</QualifierName><QualifierName MajorTopicYN="N" 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