In clinical studies, pimavanserin met the primary study endpoint by demonstrating a highly significant reduction in psychosis as compared to placebo and also met the key secondary endpoint for motoric tolerability. Also reported in the controlled study were highly significant improvements in all secondary efficacy measures and statistically significant benefits in exploratory efficacy measures of nighttime sleep, daytime wakefulness, and caregiver burden.9

Without effective treatments for PDP, hallucinatory experiences tend to escalate, delusions become more prominent, and symptoms generally become more troubling and disabling.2 Caregivers find it increasingly difficult and stressful to manage their loved one’s condition.


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Therefore, health care providers should be vigilant in their early detection of symptoms so PDP can be promptly addressed to maintain overall quality of life and avoid clinical deterioration and unnecessary long -term placement.

Henry Nasrallah, MD, is the Sydney W. Souers Professor and Chairman of Department of Neurology and Psychiatry at Saint Louis University School of Medicine in Missouri.

Disclosure: Nasrallah is a consultant for Acadia Pharmaceuticals, the developer of pimavanserin (Nuplazid).

References

  1. Parkinson’s Disease: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care. NICE Clinical Guidelines, No. 35. National Collaborating Centre for Chronic Conditions (UK). London: Royal College of Physicians (UK); 2006. http://www.ncbi.nlm.nih.gov/books/NBK48501/. Accessed on June 2, 2015.
  2. National Institute of Neurological Disorders and Stroke (National Institutes of Health). NINDS Parkinson’s Disease Information Page. Last updated April 29, 2015. Retrieved June 1, 2015, from http://www.ninds.nih.gov/disorders/parkinsons_disease/parkinsons_disease.htm.
  3. Parkinson’s Disease Foundation. Nonmotor Symptoms. Retrieved on June 1 , 2015 http://www.pdf.org/symptoms_nonmotor_early.
  4. Salawu FK et al. Non-motor symptoms of Parkinson’s disease: diagnosis and management. Niger J Med. 2010; 19(2):126-31. http://www.ncbi.nlm.nih.gov/pubmed/20642073.
  5. Schrag A et al. Caregiver-burden in Parkinson’s disease is closely associated with psychiatric symptoms, falls, and disability. Parkinsonism Relat Disord. 2006; 12(1):35-41. Retrieved June 1, 2015, from http://www.ncbi.nlm.nih.gov/pubmed/16271496.
  6. Fenelon G et al. J Neurol Sci 2010; 289:12. Fenelon G, et al. Brain. 2000; 123:733-736.
  7. Friedman JH and Factor SA. Atypical antipsychotics in the treatment of drug-induced psychosis in Parkinson’s disease. Mov Disord. 2000; 15(2): 201-11. Retrieved on June 1, 2015. http://www.ncbi.nlm.nih.gov/pubmed/10752567.
  8. Friedman JH Treating psychosis in movement disorder patients: a review. Expert Opin Pharmacother. 2014; 15(11): 1553-64. Retrieved on June 1, 2015. http://www.ncbi.nlm.nih.gov/pubmed/24846479.
  9. Cummings J et al. Pimavanserin for patients with Parkinson’s disease psychosis: a randomised, placebo-controlled phase 3 trial. Lancet. 2014; 383(9916): 533-540. Retrieved June 1, 2015. http://dx.doi.org/10.1016/S0140-6736(13)62106-6.

This article originally appeared on Psychiatry Advisor