Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Parkinson's Disease Health Center

Font Size

Antipsychotics Used for Parkinson's Despite Warnings

Doctors Still Prescribe Antipsychotics Despite Risks for Some Parkinson's Patients
WebMD Health News
Reviewed by Louise Chang, MD

July 11, 2011 -- Doctors continue to prescribe antipsychotic drugs to their patients with Parkinson's disease and psychosis, despite "black box" warnings from the FDA linking them to increased risk of death among patients with dementia, a study shows.

A black box warning is the strongest drug warning issued by the FDA.

"My sense is that the black box warnings don't factor into decision making," says study researcher Daniel Weintraub, MD, an associate professor of psychiatry at the University of Pennsylvania.

The study is published in the Archives of Neurology.

The black box warning for antipsychotics says the drugs are associated with an increased risk of death for those with dementia, which is common among people diagnosed with Parkinson's. Some commonly prescribed antipsychotics also worsen symptoms of Parkinson's.

Risperdal (risperidone) and Zyprexa (olanzapine), for example, are two such drugs, and neither has been shown to be very effective. Yet according to the study, nearly 30% of patients with Parkinson's and psychosis take them.

Clozaril (clozapine), the only drug known to be both effective and well-tolerated for treating psychosis in Parkinson's patients, is prescribed to less than 2% of those with the disease.

"The gold standard treatment is also one of the most impractical treatments," says neurologist Hubert Fernandez, MD, a Parkinson's specialist at the Cleveland Clinic's Center for Neurological Restoration.

Because of a rare but potentially deadly side effect of the drug, patients on clozapine must have their blood monitored at regular intervals. That burden discourages many doctors from prescribing the medication.

The alternatives, however, are far from ideal. Abilify (aripiprazole), the third most commonly prescribed antipsychotic, is poorly tolerated by Parkinson's patients. And the most popular drug, Seroquel (quetiapine), has failed to show positive results in three studies.

"Quetiapine is the No. 1 choice without clear evidence that it's effective," says Weintraub.

Lack of Treatment Alternatives

The researchers examined Department of Veterans Affairs patient records from fiscal year 2008, comparing the rates of antipsychotic drug prescriptions among two groups: 2,597 patients with Parkinson's disease and psychosis with and without dementia and 6,907 patients with dementia and psychosis but without Parkinson's disease; 97.3% of the patients studied were men.

Today on WebMD

Parkinsons disease illustration
Causes, symptoms, and treatments.
hands on walker
How does the disease progress?
man with serious expression
8 common questions and answers.
intelligence quotient illustration
What are the advantages of DBS?
Parkinsons Disease Medications
Questions Doctor Parkinsons
Eating Right
Parkinsons Exercise
daughter consoling depressed mother
senior man's hands
Parkinsons Daily