Aripiprazole for drug-induced psychosis in Parkinson disease: preliminary experience

Clin Neuropharmacol. Jan-Feb 2004;27(1):4-5. doi: 10.1097/00002826-200401000-00003.

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.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antipsychotic Agents / therapeutic use*
  • Aripiprazole
  • Dementia / chemically induced
  • Dementia / complications
  • Dementia / drug therapy*
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Disorders / drug therapy*
  • Mental Disorders / etiology
  • Middle Aged
  • Parkinson Disease / complications*
  • Piperazines / therapeutic use*
  • Quinolones / therapeutic use*

Substances

  • Antipsychotic Agents
  • Piperazines
  • Quinolones
  • Aripiprazole