Clozapine prevents recurrence of psychosis in Parkinson's disease.
Identifieur interne : 004D72 ( PubMed/Curation ); précédent : 004D71; suivant : 004D73Clozapine prevents recurrence of psychosis in Parkinson's disease.
Auteurs : S A Factor [États-Unis] ; D. BrownSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1992.
English descriptors
- KwdEn :
- Activities of Daily Living (psychology), Aged, Antiparkinson Agents (adverse effects), Antiparkinson Agents (therapeutic use), Clozapine (adverse effects), Clozapine (therapeutic use), Dopamine Agents (adverse effects), Dopamine Agents (therapeutic use), Dose-Response Relationship, Drug, Female, Humans, Levodopa (adverse effects), Levodopa (therapeutic use), Male, Middle Aged, Neurologic Examination (drug effects), Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Parkinson Disease (psychology), Psychiatric Status Rating Scales, Psychoses, Substance-Induced (diagnosis), Psychoses, Substance-Induced (drug therapy), Psychoses, Substance-Induced (psychology), Sleep Stages (drug effects).
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Clozapine, Dopamine Agents, Levodopa.
- diagnosis : Parkinson Disease, Psychoses, Substance-Induced.
- drug effects : Neurologic Examination, Sleep Stages.
- drug therapy : Parkinson Disease, Psychoses, Substance-Induced.
- psychology : Activities of Daily Living, Parkinson Disease, Psychoses, Substance-Induced.
- chemical , therapeutic use : Antiparkinson Agents, Clozapine, Dopamine Agents, Levodopa.
- Aged, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales.
Abstract
Psychosis secondary to dopaminergic therapy can limit the ability to manage motor symptoms of advanced Parkinson's disease (PD). We report the results of an open label 3-month trial that evaluated the antipsychotic effects of clozapine in eight PD patients with drug-induced psychosis. Response was quantified using a simplified brief psychiatric rating scale and two PD scales. Clozapine significantly improved psychiatric scores at low doses. The use of every other day regimens (not previously utilized) led to good control of symptoms and minimized side effects. Clozapine also had a positive sleep effect in four patients and improved dyskinesia in one. Finally, this treatment prevented recurrence of psychosis while levodopa doses were significantly increased and while other antiparkinsonian medications were added. Motor disability related to PD improved as a result of these treatment adjustments. We conclude that clozapine is effective in treating drug-induced psychosis in PD and allows for safe optimization of antiparkinsonian therapy.
DOI: 10.1002/mds.870070205
PubMed: 1350059
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pubmed:1350059Le document en format XML
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<author><name sortKey="Factor, S A" sort="Factor, S A" uniqKey="Factor S" first="S A" last="Factor">S A Factor</name>
<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Albany Medical College, NY 12208.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">État de New York</region>
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<wicri:cityArea>Department of Neurology, Albany Medical College</wicri:cityArea>
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<author><name sortKey="Brown, D" sort="Brown, D" uniqKey="Brown D" first="D" last="Brown">D. Brown</name>
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<author><name sortKey="Factor, S A" sort="Factor, S A" uniqKey="Factor S" first="S A" last="Factor">S A Factor</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living (psychology)</term>
<term>Aged</term>
<term>Antiparkinson Agents (adverse effects)</term>
<term>Antiparkinson Agents (therapeutic use)</term>
<term>Clozapine (adverse effects)</term>
<term>Clozapine (therapeutic use)</term>
<term>Dopamine Agents (adverse effects)</term>
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<term>Dose-Response Relationship, Drug</term>
<term>Female</term>
<term>Humans</term>
<term>Levodopa (adverse effects)</term>
<term>Levodopa (therapeutic use)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neurologic Examination (drug effects)</term>
<term>Parkinson Disease (diagnosis)</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (psychology)</term>
<term>Psychiatric Status Rating Scales</term>
<term>Psychoses, Substance-Induced (diagnosis)</term>
<term>Psychoses, Substance-Induced (drug therapy)</term>
<term>Psychoses, Substance-Induced (psychology)</term>
<term>Sleep Stages (drug effects)</term>
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<term>Clozapine</term>
<term>Dopamine Agents</term>
<term>Levodopa</term>
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<term>Psychoses, Substance-Induced</term>
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<term>Sleep Stages</term>
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<term>Psychoses, Substance-Induced</term>
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<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Activities of Daily Living</term>
<term>Parkinson Disease</term>
<term>Psychoses, Substance-Induced</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term>
<term>Clozapine</term>
<term>Dopamine Agents</term>
<term>Levodopa</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Dose-Response Relationship, Drug</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Psychiatric Status Rating Scales</term>
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<front><div type="abstract" xml:lang="en">Psychosis secondary to dopaminergic therapy can limit the ability to manage motor symptoms of advanced Parkinson's disease (PD). We report the results of an open label 3-month trial that evaluated the antipsychotic effects of clozapine in eight PD patients with drug-induced psychosis. Response was quantified using a simplified brief psychiatric rating scale and two PD scales. Clozapine significantly improved psychiatric scores at low doses. The use of every other day regimens (not previously utilized) led to good control of symptoms and minimized side effects. Clozapine also had a positive sleep effect in four patients and improved dyskinesia in one. Finally, this treatment prevented recurrence of psychosis while levodopa doses were significantly increased and while other antiparkinsonian medications were added. Motor disability related to PD improved as a result of these treatment adjustments. We conclude that clozapine is effective in treating drug-induced psychosis in PD and allows for safe optimization of antiparkinsonian therapy.</div>
</front>
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<Abstract><AbstractText>Psychosis secondary to dopaminergic therapy can limit the ability to manage motor symptoms of advanced Parkinson's disease (PD). We report the results of an open label 3-month trial that evaluated the antipsychotic effects of clozapine in eight PD patients with drug-induced psychosis. Response was quantified using a simplified brief psychiatric rating scale and two PD scales. Clozapine significantly improved psychiatric scores at low doses. The use of every other day regimens (not previously utilized) led to good control of symptoms and minimized side effects. Clozapine also had a positive sleep effect in four patients and improved dyskinesia in one. Finally, this treatment prevented recurrence of psychosis while levodopa doses were significantly increased and while other antiparkinsonian medications were added. Motor disability related to PD improved as a result of these treatment adjustments. We conclude that clozapine is effective in treating drug-induced psychosis in PD and allows for safe optimization of antiparkinsonian therapy.</AbstractText>
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