[Clozapine for the treatment of psychosis in 3 elderly patients with Parkinson's disease].
Three patients with Parkinson's disease developed psychosis. None of the three showed any other somatic cause for the psychosis except the Parkinson's disease. The first patient, a 73-year-old male, was initially treated with olanzapine and rivastigmine, without any effect. While treating the second patient, a 75-year-old male who had been suffering from Parkinson's disease for years, the Parkinson medication was first reduced and later on olanzapine and rivastigmine were prescribed, without a lasting effect on the psychotic symptoms. In the third patient, an 85-year-old male, medication reduction was unsuccessful. Finally, all three were treated effectively with clozapine. Psychosis in Parkinson's disease is a serious disorder that is often difficult to treat. In most cases, antipsychotic medication is needed. The atypical antipsychotic clozapine is effective without aggravation of the motor symptoms. Despite the side effects, such as the risk of agranulocytosis, drowsiness and weight gain, clozapine should be considered as a possible treatment.
Diraoui
S
S
Universitair Medisch Centrum Utrecht, afd. Geriatrie.
van Melick
E J M
EJ
Jansen
P A F
PA
D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D003024:Clozapine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D018696:Neuroprotective Agents / Q000627:therapeutic use; D000077152:Olanzapine; D010300:Parkinson Disease / Q000150:complications*; D048448:Phenylcarbamates / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000209:etiology; D000068836:Rivastigmine; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D001569:Benzodiazepines; D003024:Clozapine; D000077152:Olanzapine; D000068836:Rivastigmine