Department of Neurology, Houston Methodist Neurological Institute, 6560 Fannin Street; Scurlock Tower, Suite 802, Houston, TX, 77030, USA.
Curr Psychiatry Rep. 2018 Jan 27;20(1):3. doi: 10.1007/s11920-018-0869-z.
We discuss features of Parkinson's disease psychosis (PDP) including symptomology and pathophysiology. Treatment options, including non-pharmacologic strategies, dose reduction of offending agents, and the addition of non-dopaminergic antipsychotics, are addressed. The efficacy of second-generation antipsychotics and novel agents is examined.
Pimavanserin, a 5-HT receptor inverse agonist with no other receptor activity, has shown efficacy and tolerability and is now FDA approved for PDP treatment. Research into novel targets is ongoing. PDP is a morbid complication of Parkinson's disease with complex incompletely understood mechanisms. Treatment is directed towards mitigation of psychosis without worsening of motor features.
我们讨论了帕金森病精神病(PDP)的特征,包括症状学和发病机制。讨论了治疗选择,包括非药物策略、降低致病药物剂量以及添加非多巴胺能抗精神病药。检查了第二代抗精神病药和新型药物的疗效。
Pimavanserin 是一种 5-HT 受体反向激动剂,没有其他受体活性,已显示出疗效和耐受性,现已获得 FDA 批准用于治疗 PDP。对新靶点的研究正在进行中。PDP 是帕金森病的一种严重并发症,其机制复杂且尚未完全了解。治疗的目的是减轻精神病而不加重运动症状。