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Drug Shows Promise in Treating Parkinson's Psychosis

Pimavanserin may have fewer side effects than current therapy, study suggests
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WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

THURSDAY, Oct. 31 (HealthDay News) -- Many people living with Parkinson's disease suffer from hallucinations and delusions, but an experimental drug might offer some relief without debilitating side effects.

The drug -- pimavanserin -- appears to significantly relieve these troubling symptoms, according to the results of a phase 3 trial to test its effectiveness.

Such symptoms affect as many as half of the estimated 7 million to 10 million Parkinson's patients around the world, according to study background information.

Currently, patients are treated with antipsychotic drugs such as clozapine and quetiapine, which worsen Parkinson's motor symptoms, hasten mental decline, increase the risk of stroke and can be life-threatening, authors of the new study said.

Their study was published in the Nov. 1 online issue of The Lancet and funded by Acadia Pharmaceuticals, the makers of pimavanserin.

"There are no first-line approved treatments for psychosis in people with Parkinson's disease," said lead researcher Dr. Clive Ballard, a professor of age-related diseases at King's College, London.

"Existing antipsychotics are either ineffective or not tolerated. Pimavanserin is not yet licensed, but could potentially offer a change in the treatment of these distressing and impactful symptoms," he said.

An expert not involved with the study talked about the need for a medication alternative.

"The Parkinson's disease community has been waiting for a potentially new approach for the treatment of psychosis and hallucinations," said Dr. Michael Okun, national medical director of the National Parkinson Foundation.

"Pimavanserin may offer a relatively safe and reasonably efficacious choice for many patients in the situation where the current therapies are not adequate," Okun added.

The new drug works differently from other antipsychotics, study author Ballard said.

Pimavanserin blocks certain receptors -- called serotonin 5-HT2A receptors -- in the neocortex of the brain. This part of the brain is responsible for sensory perceptions, conscious thought and language, and is associated with hallucinations and delusions, Ballard explained.

For the trial, Ballard's team randomly assigned 199 Parkinson's patients suffering from disease-associated psychosis to daily doses either of pimavanserin or an inactive placebo pill.

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