Neuroleptic sensitivity in Parkinson's disease and parkinsonian dementias

J Clin Psychiatry. 2005 May;66(5):633-7.


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).

Method: 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.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / drug therapy
  • Alzheimer Disease / psychology
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Dementia / diagnosis
  • Dementia / drug therapy*
  • Dementia / psychology
  • Female
  • Humans
  • Lewy Body Disease / diagnosis
  • Lewy Body Disease / drug therapy
  • Lewy Body Disease / psychology
  • Male
  • Neuroleptic Malignant Syndrome / diagnosis
  • Neuroleptic Malignant Syndrome / epidemiology
  • Neuroleptic Malignant Syndrome / etiology*
  • Parkinson Disease / diagnosis
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / psychology
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Severity of Illness Index


  • Antipsychotic Agents