Reference

Treating dopamimetic psychosis in Parkinson's disease: Structured review and meta-analysis

All Rights Reserved. Treating dopamimetic psychosis in Parkinson's disease: Structured review and meta-analysis. Frieling, Helge; Hillemacher, Thomas; Ziegenbein, Marc; Neundoerfer, Bernhard; Bleich, Stefan (Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen 91054, Germany). European Neuropsychopharmacology, 17(3), 165-171 (English) 2007 Elsevier Ltd. CODEN: EURNE8. ISSN: 0924-977X. DOCUMENT TYPE: Journal CA Section: 1 (Pharmacology) Psychosis due to dopamimetic treatment is a difficult problem in patients with Parkinson's disease (PD). The aim of this structured review with meta-anal. was to evaluate which neuroleptic drugs can efficiently be used to treat drug-induced psychosis (DIP) in Parkinson's disease. Electronic databases were screened for the key words Parkinson's disease and psychosis. Only 7 trials with a satisfactory allocation concealment and data reporting were included into the study. Two trials compared low-dose clozapine vs. placebo with a significantly better outcome for clozapine regarding efficacy and motor functioning. In one trial clozapine was compared against quetiapine showing equiv. efficacy and tolerability. However, in two placebo controlled trials quetiapine failed to show efficacy. In two further placebo controlled trials olanzapine did not improve psychotic symptoms and significantly caused more extrapyramidal side effects. Based on randomized trial-derived evidence which is currently available, only clozapine can be fully recommended for the treatment of DIP in PD. Olanzapine should not be used in this indication.Except for chemicals metioned above, 132539-06-1 and 111974-69-7 are also used. .

Quetiapine to treat agitation in dementia: a randomized, double-blind, placebo-controlled study

All Rights Reserved. Quetiapine to treat agitation in dementia: a randomized, double-blind, placebo-controlled study. Zhong, Kate X.; Tariot, P. N.; Mintzer, J.; Minkwitz, M. C.; Devine, N. A. (Wilmington, DE 19850-5437, USA). Current Alzheimer Research, 4(1), 81-93 (English) 2007 Bentham Science Publishers Ltd. CODEN: CARUBY. ISSN: 1567-2050. DOCUMENT TYPE: Journal CA Section: 1 (Pharmacology) In this 10-wk, double-blind, fixed-dose study, elderly institutionalized patients with dementia and agitation were randomized (3:3:2) to quetiapine 200mg/day, 100mg/day, or placebo. The primary endpoint was change in Pos. and Neg. Syndrome Scale (PANSS)-Excitement Component (EC) scores at endpoint, analyzed using last observation carried forward (LOCF) and obsd. cases (OC) approaches. Other efficacy measures were the Clin. Global Impression of Change (CGI-C), and response rates (percentage with 340% redn. [PANSS-EC]; "much" or "very much improved" [CGI-C]), Neuropsychiatric Inventory-Nursing Home version (NPI-NH), and Cohen-Mansfield Agitation Inventory (CMAI). The key safety measure was incidence of adverse events; change in Mini-Mental State Examn. (MMSE) was also assessed. Baseline characteristics of 333 participants (quetiapine 200mg/day, n = 117; quetiapine 100mg/day, n = 124; placebo, n = 92) and completion rates (63-65%) were comparable among groups. Compared with placebo, quetiapine 200mg/day was assocd. with clin. greater improvements in PANSS-EC (LOCF, p = 0.065; OC, p = 0.014 [ANCOVA]), CGI-C (LOCF, p = 0.017; OC, p = 0.002 [ANOVA]), and CGI-C response rates (LOCF, p = 0.002; OC, p<0.001 [Chi-square test]). Quetiapine 100mg/day did not differentiate from placebo on these measures. There were no between-group differences in NPI-NH or CMAI. Incidences of cerebrovascular adverse events, postural hypotension, and falls were similar among groups. MMSE did not change in any group. Mortality was numerically higher in the quetiapine groups; rates were not statistically different from placebo. 111974-69-7 is just another one chemical used in this study. The results of this study suggest that quetiapine 200mg/day was effective and well-tolerated for treating agitation assocd. with dementia. However, caution should be exercised given the concerns regarding increased mortality with atypical antipsychotics in this vulnerable patient population. .