Pimavanserin for the treatment of Parkinson's disease psychosis

  title={Pimavanserin for the treatment of Parkinson's disease psychosis},
  author={Joseph H. Friedman},
  journal={Expert Opinion on Pharmacotherapy},
  pages={1969 - 1975}
  • J. Friedman
  • Published 10 September 2013
  • Psychology, Medicine
  • Expert Opinion on Pharmacotherapy
Introduction: Parkinson's disease (PD) is a neurobehavioral disorder defined by its motor features. Its treatment is frequently complicated by the presence of psychotic symptoms, most prominently hallucinations and delusions. These cause major distress and are the primary cause for nursing home placement. Current treatment requires either a reduction in medications for mobility or the addition of atypical antipsychotics, none of which are approved in the United States, and which are associated… 

Pimavanserin for Psychotic Symptoms in People With Parkinsonism: A Second Chart Review

  • J. Friedman
  • Medicine, Psychology
    Clinical neuropharmacology
  • 2018
Almost 50% of parkinsonian patients with psychotic symptoms found Pim to be a useful medication, which they continue to take, according to a chart review of all patients started on the drugs since the one earlier report.

Treating psychosis in movement disorder patients: a review

Evidence is presented that clozapine is currently the drug of choice for treating psychosis in patients with parkinsonism; however, blood monitoring requirements make it difficult to use.

A Novel Synthesis of Pimavanserin: A Selective Serotonin 5-HT2A Receptor Inverse Agonist

Psychosis in patients with Parkinson’s disease (PD) is a common, at times debilitating, condition and represents a major unmet need in the treatment of PD. Pimavanserin

Targeting Serotonin 5-HT2A Receptors to Better Treat Schizophrenia: Rationale and Current Approaches

The evidence for the role of the serotonin type 2A receptor (5-HT2AR) in schizophrenia is assessed and Food and Drug Administration (FDA)-approved and investigational 5- HT2AR-modulating compounds are reviewed.

Psychosis as a Treatment Target in Dementia: A Roadmap for Designing Interventions

The work emphasizes the need for better definition and measurement of psychotic symptoms in dementias in order to highlight their differences with symptoms that appear in non-dementing diseases such as schizophrenia.

PET Imaging of the 5-HT 2A Receptor System: A Tool to Study the Receptor’s In Vivo Brain Function

The serotonergic 5-HT2A receptor system plays a key modulatory role for many brain functions such as regulation of mood, temperature, sex, appetite and emotions and makes it an obvious target for many drugs.



Aripiprazole associated with severe exacerbation of Parkinson's disease

Aripiprazole is a novel atypical antipsychotic with an apparently unique mechanism of action—a dopamine system stabilizer with partial agonist effect at D2 and 5HT1a receptors that would treat psychotic symptoms in Parkinson’s disease with fewer extrapyramidal side effects.

Parkinson Disease Psychosis: Update

  • J. Friedman
  • Psychology, Medicine
    Behavioural neurology
  • 2013
Only clozapine has level A evidence to support its use in PD patients with psychosis (PDP), whether demented or not, and other antipsychotic drugs have been reported to worsen motor function and data on the effectiveness of cholinesterase inhibitors is limited.

Parkinson's disease: The quintessential neuropsychiatric disorder

  • D. WeintraubD. Burn
  • Psychology, Medicine
    Movement disorders : official journal of the Movement Disorder Society
  • 2011
The emergent focus on nonmotor aspects of Parkinson's disease over the past quarter of a century is highlighted by a nonlinear increase in the number of articles published devoted to this topic.

Pimavanserin, a Serotonin2A Receptor Inverse Agonist, for the Treatment of Parkinson's Disease Psychosis

Pimavanserin showed significantly greater improvement in psychosis in patients with PDP at a dose which did not impair motor function, or cause sedation or hypotension, which support the hypothesis that attenuation of psychosis secondary to DA receptor stimulation in PDP may be achieved through selective 5-HT2A receptor antagonism.

Epidemiology of psychosis in Parkinson's disease

Diagnostic criteria for psychosis in Parkinson's disease: Report of an NINDS, NIMH work group

  • B. RavinaK. Marder C. Goetz
  • Psychology, Medicine
    Movement disorders : official journal of the Movement Disorder Society
  • 2007
It is suggested that PDPsy may result from progression of the disease process underlying PD, rather than a comorbid psychiatric disorder or drug intoxication, and are a potential indication for therapy development.

Psychiatric syndromes in Parkinson's disease

Standardized criteria should be used to diagnose depression and apathy in Parkinson's disease and psychotherapy and pharmacotherapy are useful treatment modalities for affective disorders in Parkinson’s disease.

Drug-Induced Psychosis in Parkinson Disease: Phenomenology and Correlations Among Psychosis Rating Instruments

Nonvisual hallucinations and delusions may occur more frequently in DIP than previously thought and these symptoms, plus agitation and hostility, may ultimately be the best measure of DIP in patients with PD.

Aripiprazole for Drug-Induced Psychosis in Parkinson Disease: Preliminary Experience

The preliminary experience in 8 patients with probable Parkinson disease treated with aripiprazole for drug-induced psychosis is mixed but not very encouraging, and controlled studies are needed to evaluate aripIPrazole in parkinsonian patients.

Pimavanserin, a 5-HT2A inverse agonist, reverses psychosis-like behaviors in a rodent model of Parkinson's disease

Pimavanserin, a selective 5- HT2A antagonist/inverse agonist, reversed the psychotic-like behavioral deficits, suggesting that nigrostriatal (6-hydroxydopamine) lesions induced alterations in 5-HT2A-mediated signaling.