Continuous subcutaneous infusion of apomorphine can be used safely in patients with Parkinson's disease and pre-existing visual hallucinations

Laar, Teus van; Postma, Anna G.; Drent, Martje

doi:10.1016/j.parkreldis.2009.05.006

Cited by 48 publications

(34 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PD patients with VH (n=8) demonstrated an improvement in neuropsychiatric symptoms (measured using the Neuropsychiatric Inventory Questionnaire (NPI-Q), evident after only a week of apomorphine treatment and persisting six weeks later. These findings suggest that apomorphine may be prescribed in PD patients with VH provided there is concomitant reduction in the dose of oral dopamine agonists and/or adequate treatment of existing cognitive deficits [12].…”

Section: B) Apomorphinementioning

confidence: 94%

“…No worsening of VH has been reported in advanced PD patients receiving apomorphine treatment with long-term follow-up in descriptive studies [63][64][65][66] and apomorphine has even been suggested to have a beneficial effect on VH [9,12]. The antipsychotic potential of apomorphine was first reported in patients diagnosed with schizophrenia [67,68].…”

Section: B) Apomorphinementioning

confidence: 99%

“…Support for these observations has come from a more recent open-label clinical trial, in which treatment with oral dopamine agonists was replaced with apomorphine [12]. PD patients with VH (n=8) demonstrated an improvement in neuropsychiatric symptoms (measured using the Neuropsychiatric Inventory Questionnaire (NPI-Q), evident after only a week of apomorphine treatment and persisting six weeks later.…”

Section: B) Apomorphinementioning

confidence: 99%

“…This piperidine moiety is also incorporated in the chemical structure of many antipsychotic medications, including piperidine phenothiazines, haloperidol, risperdone, bulbocapnine and other aporphines [75,76]. Based on the structural similarities, it has been argued that the antipsychotic potential of apomorphine is due to the specific action of this piperidine moiety in binding to dopaminergic and serotonergic receptors (particularly 5-HT2A-receptors), producing an antagonistic effect [9,12,[76][77][78].…”

Section: Chemical Structure and Receptor Binding Profile Of Apomorphinementioning

confidence: 99%

“…This suggests that VH are not directly caused by dopaminergic overstimulation, but that treatment may act as a precipitating factor. In contrast, evidence from a number of case series and a single open-label prospective trial suggest that apomorphine (potent dopamine agonist) has the potential to alleviate some of the symptoms of VH [9][10][11][12].…”

Section: Introductionmentioning

confidence: 96%

See 4 more Smart Citations

Parkinson's disease, visual hallucinations and apomorphine: A review of the available evidence

Borgemeester

Lees²,

Laar

2016

Parkinsonism & Related Disorders

Self Cite

View full text Add to dashboard Cite

show abstract

Section: B) Apomorphinementioning

confidence: 94%

Section: B) Apomorphinementioning

confidence: 99%

Section: B) Apomorphinementioning

confidence: 99%

Section: Chemical Structure and Receptor Binding Profile Of Apomorphinementioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 3 more Smart Citations

Parkinson's disease, visual hallucinations and apomorphine: A review of the available evidence

Borgemeester

Lees²,

Laar

2016

Parkinsonism & Related Disorders

Self Cite

View full text Add to dashboard Cite

show abstract

Continuous Subcutaneous Infusion Delivery of Apomorphine in Parkinson's Disease: A Systematic Review

Kukkle

Garg

Merello

2023

Movement Disord Clin Pract

View full text Add to dashboard Cite

BackgroundContinuous subcutaneous apomorphine infusion (CSAI) is one of the advanced therapies for Parkinson's disease (PD).MethodsA systematic review of all published articles in English on CSAI for PD till January 30, 2022 was conducted.ResultsA total of 82 articles met the search criteria. Publications included retrospective or prospective open‐label observational studies, with a limited number of randomized control trials (RCT). Publications were highly heterogeneous and focused on different aspects of CSAI and included clinical audits, effects on cognition/behavior, axial symptoms, nocturnal issues, adverse events/reasons for discontinuation and comparison with other continuous dopaminergic therapies. CSAI was used in patients who presented severe motor fluctuations not resolved by oral therapy, poor candidates for deep brain stimulation (DBS) due to cognitive/behavioral issues or in those with DBS weaning effect. Recent studies have also shown that CSAI was useful for nocturnal usage in advanced PD, in addition to daytime utilization. Adverse effects were common and include skin lesions, sedation and nausea. Pump management difficulties and patient decisions were common reasons for therapy dropout, predominantly during the initial stages of the CSAI.ConclusionThere is consistent agreement on the benefits of CSAI in reducing OFF periods and improving ON periods without troublesome dyskinesia and specific motor and non‐motor symptoms. Although there is a paucity of RCTs, current data from almost 30 years of use suggests CSAI to be beneficial in advanced cases of PD.

show abstract

How to Use the New European Academy of Neurology/Movement Disorder Society European Section Guideline for Invasive Therapies in Parkinson's Disease

Brinker,

Smilowska,

Paschen

et al. 2024

Movement Disord Clin Pract

View full text Add to dashboard Cite

BackgroundThe decision to choose invasive treatments for Parkinson's disease (PD) is complex and needs careful consideration.ObjektivesAlthough the recommendations of the EAN/MDS‐ES guideline for invasive therapies of PD are useful, the different clinical profiles of people with PD who seek advice for possible invasive therapy need further attention.Methods and ResultsHere we describe eight clinical standard situations of people with PD unsatisfied with their current oral treatment where invasive therapies may be considered. These are PD patients presenting with (1) severe motor fluctuations, (2) beginning of levodopa‐responsive fluctuations, severe tremor at (3) young or (4) advanced age, (5) impulse control disorders and related behavioural disorders, (6) hallucinations and psychosis, (7) minimal cognitive impairment or mild dementia and (8) patients in palliative care need. For some of these conditions evidence at lower level or simple clinical considerations exist.ConclusionsThere are no one‐fits‐all answers, but physician and patient should discuss each option carefully considering symptom profile, psychosocial context, availability of therapy alternatives, and many other factors. The current paper outlines our proposed approach to these circumstances.This article is protected by copyright. All rights reserved.

show abstract

Continuous subcutaneous infusion of apomorphine can be used safely in patients with Parkinson's disease and pre-existing visual hallucinations

Cited by 48 publications

References 4 publications

Parkinson's disease, visual hallucinations and apomorphine: A review of the available evidence

Parkinson's disease, visual hallucinations and apomorphine: A review of the available evidence

Continuous Subcutaneous Infusion Delivery of Apomorphine in Parkinson's Disease: A Systematic Review

How to Use the New European Academy of Neurology/Movement Disorder Society European Section Guideline for Invasive Therapies in Parkinson's Disease

Contact Info

Product

Resources

About