Long-term outcome of quetiapine use for psychosis among Parkinsonian patients.
To evaluate the long-term efficacy and tolerability of quetiapine for psychosis among parkinsonian patients, a retrospective analysis of all parkinsonian patients taking quetiapine for psychosis in a single movement disorders center was carried out. Demographic data, including type and severity of psychosis, presence of dementia, treatment response, before and after Unified Parkinson's Disease Rating Scale (UPDRS)-motor scores and Hoehn and Yahr (H&Y) scale were obtained. One hundred six parkinsonian patients with a mean age of 76.6 years were on an average levodopa (L-dopa) dose of 415 mg/d. Seventy-eight of 106 (74%) remained on quetiapine for a mean duration of 15 months at an average dose of 60 mg per day. Eighty-seven (82%) patients had partial or complete resolution of their psychosis whereas 19 (18%) patients had no improvement on quetiapine. Motor worsening was noted in 34 (32%) patients but was uncommonly sufficient to warrant quetiapine discontinuation. More quetiapine non-responders were noted to be demented, delusional, and experienced threatening psychosis but only the presence of dementia remained significant on multivariate analysis (OR = 11.6; 95% CI = 1.4-92.9). Also, patients who developed motor worsening while on quetiapine tended to be more demented (P = 0.07).
Department of Clinical Neurosciences, Brown University School of Medicine, Providence, Rhode Island, USA. Hubert-Fernandez@mhri.org
Hubert H
HH
Fernandez
Martha E
ME
Trieschmann
Monica A
MA
Burke
Carol
C
Jacques
Joseph H
JH
Friedman
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003987:Dibenzothiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D004361:Drug Tolerance; D004409:Dyskinesia, Drug-Induced / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000188:drug therapy / Q000523:psychology*; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology*; D000069348:Quetiapine Fumarate; D012189:Retrospective Studies; D012720:Severity of Illness Index
D000978:Antiparkinson Agents; D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate; D007980:Levodopa