ParkinsonFranceV1, Ncbi, Curation, bibRecord, 000434

Clozapine in drug induced psychosis in Parkinson's disease: a randomised, placebo controlled study with open follow up

Identifieur interne : 000434 ( Ncbi/Curation ); précédent : 000433; suivant : 000435

Clozapine in drug induced psychosis in Parkinson's disease: a randomised, placebo controlled study with open follow up

Auteurs : P. Pollak ; F. Tison ; O. Rascol ; A. Destee ; J. Pere ; J. Senard ; F. Durif ; I. Bourdeix

Source :

Journal of Neurology, Neurosurgery, and Psychiatry [ 0022-3050 ] ; 2004.

RBID : PMC:1763590

English descriptors

KwdEn :
- Aged, Clozapine (administration & dosage), Clozapine (therapeutic use), Dose-Response Relationship, Drug, Double-Blind Method, Feasibility Studies, Female, Follow-Up Studies, GABA Antagonists (administration & dosage), GABA Antagonists (adverse effects), Humans, Levodopa (adverse effects), Male, Parkinson Disease (drug therapy), Prospective Studies, Psychoses, Substance-Induced (diagnosis), Psychoses, Substance-Induced (etiology).
MESH :
- chemical , administration & dosage : Clozapine, GABA Antagonists.
- chemical , adverse effects : GABA Antagonists, Levodopa.
- chemical , therapeutic use : Clozapine.
- diagnosis : Psychoses, Substance-Induced.
- drug therapy : Parkinson Disease.
- etiology : Psychoses, Substance-Induced.
- Aged, Dose-Response Relationship, Drug, Double-Blind Method, Feasibility Studies, Female, Follow-Up Studies, Humans, Male, Prospective Studies.

Abstract

Objective: To compare the efficacy and safety of clozapine in drug induced psychosis in Parkinson's disease (PD).

Methods: A four week, randomised, double blind, parallel comparison of clozapine and placebo, followed by a 12 week clozapine open period, plus a one month period after drug discontinuation, in 60 patients with PD. The primary efficacy outcome was the "clinical global impression scale" (CGI); the positive subscore of the "positive and negative syndrome scale" (PANSS) was used as the secondary efficacy parameter and the "unified Parkinson's disease rating scale" (UPDRS) and the "mini mental test examination" (MMSE) as safety outcomes.

Results: The mean (SD) dosage of clozapine was 35.8 (12.5–50) mg at the end of the double blind period. The mean (SD) scores on the CGI improved by 1.8 (1.5) for the clozapine group compared with 0.6 (1.1) for the placebo group (p = 0.001). The mean (SD) positive subscore of PANSS improved by 5.6 (3.9) for the clozapine group (0.8 (2.8) for the placebo group; p < 0.0001). At the end of the open period, 25 patients had completely recovered from delusions and hallucinations, and 19 experienced a relapse within one month after the clozapine washout period. The UPDRS motor and MMSE mean scores did not change significantly in either group. Somnolence was more frequent with clozapine than with placebo.

Conclusions: Clozapine at a mean dose lower than 50 mg/day improves drug induced psychosis in PD without significant worsening of motor function, and the effect wears off once the treatment stops.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1763590

DOI: 10.1136/jnnp.2003.029868
PubMed: 15090561
PubMed Central: 1763590

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PMC:1763590

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<author><name sortKey="Rascol, O" sort="Rascol, O" uniqKey="Rascol O" first="O" last="Rascol">O. Rascol</name>
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<front><div type="abstract" xml:lang="en"><p><bold>Objective:</bold>
 To compare the efficacy and safety of clozapine in drug induced psychosis in Parkinson's disease (PD). </p>
<p><bold>Methods:</bold>
 A four week, randomised, double blind, parallel comparison of clozapine and placebo, followed by a 12 week clozapine open period, plus a one month period after drug discontinuation, in 60 patients with PD. The primary efficacy outcome was the "clinical global impression scale" (CGI); the positive subscore of the "positive and negative syndrome scale" (PANSS) was used as the secondary efficacy parameter and the "unified Parkinson's disease rating scale" (UPDRS) and the "mini mental test examination" (MMSE) as safety outcomes. </p>
<p><bold>Results:</bold>
 The mean (SD) dosage of clozapine was 35.8 (12.5–50) mg at the end of the double blind period. The mean (SD) scores on the CGI improved by 1.8 (1.5) for the clozapine group compared with 0.6 (1.1) for the placebo group (p = 0.001). The mean (SD) positive subscore of PANSS improved by 5.6 (3.9) for the clozapine group (0.8 (2.8) for the placebo group; p < 0.0001). At the end of the open period, 25 patients had completely recovered from delusions and hallucinations, and 19 experienced a relapse within one month after the clozapine washout period. The UPDRS motor and MMSE mean scores did not change significantly in either group. Somnolence was more frequent with clozapine than with placebo. </p>
<p><bold>Conclusions:</bold>
 Clozapine at a mean dose lower than 50 mg/day improves drug induced psychosis in PD without significant worsening of motor function, and the effect wears off once the treatment stops. </p>
</div>
</front>
</TEI>
</record>

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Clozapine in drug induced psychosis in Parkinson's disease: a randomised, placebo controlled study with open follow up

Clozapine in drug induced psychosis in Parkinson's disease: a randomised, placebo controlled study with open follow up

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Abstract

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