title: Aripiprazole for drug-induced psychosis in Parkinson disease: preliminary experience.
abstract: Aripiprazole is the newest atypical antipsychotic (AA) drug to be released in the US. It is the only AA that is a partial agonist at the D2 and 5HT1a receptors and an antagonist at 5HT2a receptors. It also has a high 5HT2/D2 ratio and may therefore carry a low risk of extrapyramidal side effects and alleviate psychosis in Parkinson-vulnerable populations. We report our preliminary experience in 8 patients with probable Parkinson disease (PD) treated with aripiprazole for drug-induced psychosis. Two patients were neuroleptic-naive, 5 patients were "quetiapine failures", and 1 patient was switched from olanzapine to aripiprazole. Aripiprazole was started at 5 mg to 10 mg a day and slowly increased over 3 to 7 days until side effects or improvement of psychosis occurred. Only 2 out of 8 patients experienced near complete resolution of their psychosis using aripiprazole. The other six patients discontinued aripiprazole within 40 days, 2 of whom discontinued due to motor worsening. Our preliminary experience with aripiprazole is mixed but not very encouraging. Controlled studies are needed to evaluate aripiprazole in parkinsonian patients.
authors.affiliation: Department of Neurology, University of Florida College of Medicine, Gainesville, FL 32610, USA.Fernandez@neurology.ufl.edu
authors.forename: Hubert H
authors.initials: HH
authors.lastname: Fernandez
authors.forename: Martha E
authors.initials: ME
authors.lastname: Trieschmann
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Friedman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000068180:Aripiprazole; D003704:Dementia / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000209:etiology; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D010879:Piperazines / Q000627:therapeutic use*; D015363:Quinolones / Q000627:therapeutic use*
chemical_list: D014150:Antipsychotic Agents; D010879:Piperazines; D015363:Quinolones; D000068180:Aripiprazole