Neuroleptic sensitivity in Parkinson's disease and parkinsonian dementias.
BACKGROUND
Severe sensitivity to neuroleptic agents is a major clinical problem in dementia with Lewy bodies (DLB), but has not been determined in Parkinson's disease (PD) and PD with dementia (PDD).


METHODS
Severe neuroleptic sensitivity reactions (NSRs) were evaluated according to an operationalized definition blind to clinical and neuropathologic diagnoses in prospectively studied patients exposed to neuroleptics from 2 centers. The study was conducted from June 1995 to May 2003.


RESULTS
Ninety-four patients were included (15 with DLB, 36 with PDD, 26 with PD, 17 with Alzheimer's disease, all diagnosed with various operational criteria). Severe NSR only occurred in patients with Lewy body disease: DLB (8 [53%]), PDD (14 [39%]), and PD (7 [27%]), but did not occur in Alzheimer's disease (p = .006). Severe NSR was not associated with other clinical or demographic features. In DLB, severe NSR was not associated with neuropathologic indices (Consortium to Establish a Registry for Alzheimer's Disease staging, Braak staging, or cortical distribution of Lewy bodies).


CONCLUSIONS
An operationalized evaluation of severe NSR blind to diagnosis confirmed the high prevalence in DLB and identified high frequencies in Parkinson's disease and PDD with important implications for clinical practice.
Aarsland
Dag
D
Section of Geriatric Psychiatry, Central Hospital, Rogaland, Stavanger, Norway.
Perry
Robert
R
Larsen
Jan P
JP
McKeith
Ian G
IG
O'Brien
John T
JT
Perry
Elaine K
EK
Burn
David
D
Ballard
Clive G
CG
D000208:Acute Disease; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003704:Dementia / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D020961:Lewy Body Disease / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D008297:Male; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index
D014150:Antipsychotic Agents