Effects of rivastigmine in patients with and without visual hallucinations in dementia associated with Parkinson's disease

Burn, David J.; Emre, Murat; McKeith, Ian G.; Deyn, Peter Paul De; Aarsland, Dag; Hsu, Chuanchieh; Lane, Roger

doi:10.1002/mds.21077

Cited by 288 publications

(140 citation statements)

References 26 publications

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“…The frequent use of antidementia agents may have been driven, in part, by comorbid dementia, as approximately half of the charts from patients with PDP who received anti-dementia agents during their course of care also reported the comorbidity. However, data from clinical trials of anti-dementia agents in the PD setting have been mixed, with some studies reporting a decrease in hallucinations, 28,29 and others reporting no improvement in neuropsychiatric symptoms. [30][31][32] We also observed, from our weighted analysis, that an estimated 16% of patients receiving treatment for PDP have been prescribed risperidone at some point during their course of care.…”

Section: Discussionmentioning

confidence: 99%

Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective

Cook¹,

Suresh²,

Lou³

et al. 2017

European Neurological Review

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Over half of patients with Parkinson’s disease (PD) develop symptoms of psychosis during the course of their disease. Existing guidelines include recommendations for managing symptoms of psychosis in patients with PD. However, the extent to which such recommendations translate to clinical practice in major European nations is unclear. The current study describes trends in the clinical management of patients diagnosed with PD psychosis (PDP) based on survey responses and patient chart reviews from 437 neurologists across France, Germany, Italy, Spain, and the UK (collectively, the EU-5). Surveyed neurologists reported that PDP typically manifests four or more years after the diagnosis of PD, with the most commonly reported initial symptoms being moderately disruptive visual hallucinations, agitation, and illusions/false sense of presence. PD medications adjustment was the most common first-line intervention, applicable to an estimated 59–79% of patients for the initial management of PDP depending on country. Responses from surveyed neurologists suggest PD medications adjustment is a temporary solution for many patients with PDP and that there is considerable variability in subsequent lines of intervention. The current report provides a resource for understanding the patterns of care and treatment for PDP across these major European nations.

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Section: Discussionmentioning

confidence: 99%

Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective

Cook¹,

Suresh²,

Lou³

et al. 2017

European Neurological Review

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“…Comparison of PD patients with and without VH has found greater degeneration of these regions in those with VH [24][25][26]. There is little in vivo clinical data of cholinergic activity in PD patients with VH with cortical cholinergic activity reduced in PD patients with dementia (PDD) compared to those without and a greater clinical response to cholinesterase inhibitors in these patients with VH compared to those without hallucinations [27][28][29]. An ongoing randomized, placebo-controlled, double-blind phase IV study is currently investigating the effect of rivastigmine in PD patients with VH without dementia (NCT01856738).…”

Section: The Role Of Acetylcholine Dopamine and Serotonin In The Devmentioning

confidence: 99%

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

Borgemeester

Lees²,

Laar

2016

Parkinsonism & Related Disorders

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“…Increased hallucinations in GBA-PD may also be explained by the predominance of Lewy body pathology. Evidence linking Lewy body pathology to visual hallucinations as well as a greater cortical cholinergic deficit helps to explain the finding that PDD subjects with visual hallucinations showed greater benefit from rivastigmine compared to those without visual hallucinations (Williams and Lees 2005;Harding et al 2002;Burn et al 2006).…”

Section: Discussionmentioning

confidence: 99%

Cognitive and Antipsychotic Medication Use in Monoallelic GBA-Related Parkinson Disease

et al. 2014

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Mutations in glucosidase, beta, acid (GBA) are associated with cognitive impairment in Parkinson disease (PD) as well as dementia with Lewy bodies. For both of these diseases, dementia and hallucinations are typically treated with cholinesterase inhibitors and antipsychotics. However, in some lysosomal storage disorders certain antipsychotic medications are poorly tolerated. This study examined cholinesterase inhibitor and antipsychotic use in monoallelic GBA-related PD to explore potential pharmacogenetic relationships. Monoallelic GBA mutation carriers with PD (GBA-PD) with at least two clinic visits (n ¼ 34) were matched for age-of-onset and gender to GBA and leucine-rich repeat kinase 2 (LRRK2) mutation negative idiopathic PD subjects (IPD) (n ¼ 60). Information regarding cholinesterase inhibitor and antipsychotic use as well as impaired cognition (UPDRS Mentation >1) and hallucinations (UPDRS Thought Disorder >1) were obtained. GBA-PD more frequently reported hallucinations (HR ¼ 5.0; p ¼ 0.01) and they were more likely to have cognitive impairment but this was not statistically significant (HR 2.2, p ¼ 0.07). Antipsychotic use was not significantly different between GBA-PD and IPD (HR ¼ 1.9; p ¼ 0.28), but GBA-PD were more likely to have sustained cholinesterase inhibitor use (HR ¼ 3.1; p ¼ 0.008), even after adjustment for cognition and hallucinations. Consistent with reports of worse cognition, GBA-PD patients are more likely to use cholinesterase inhibitors compared to IPD. While there was no difference in antipsychotic use between IPD and GBA-PD, persistent use of quetiapine in GBA-PD suggests that it is tolerated and that a significant interaction is unlikely. Further prospective study in larger samples with more extensive cognitive assessment is warranted to better understand pharmacogenetic relationships in GBA-PD.

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Effects of rivastigmine in patients with and without visual hallucinations in dementia associated with Parkinson's disease

Cited by 288 publications

References 26 publications

Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective

Parkinson’s Disease Psychosis – Patterns of Care and Treatment in the EU-5 from Neurologists’ Perspective

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

Cognitive and Antipsychotic Medication Use in Monoallelic GBA-Related Parkinson Disease

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