Psychosis in PD requiring antipsychotic therapy is frequently associated with death, nursing home placement, development and progression of dementia, and persistence of psychosis. Still, it appears the prognosis has improved with atypical antipsychotic therapy based on the finding that 28% of NH patients died within 2 years compared with 100% in a previous study done prior to availability of this treatment.
Psychoses are a common clinical problem in patients with Parkinson's disease. Treatment with typical neuroleptics or withdrawal of antiparkinsonian drugs may improve mental symptoms but will worsen the parkinsonism. Quetiapine (Seroquel), ICI 204,636, is a novel antipsychotic medication with a low potential for producing extrapyramidal side effects. In this open-label clinical study of 2 patients with Parkinson's disease, treatment with Seroquel successfully controlled psychotic symptoms without worsening of motor disability.
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