From the Guidelines
Encylextra, also known as Encylexta, is actually Pimavanserin, which is an oral medication used primarily to treat psychosis associated with Parkinson's disease. It is not mentioned in the provided evidence, which focuses on the assessment and treatment of children and adolescents with bipolar disorder 1. However, based on the most recent and highest quality studies, Pimavanserin is known to be effective in treating psychosis associated with Parkinson's disease, with a recommended dose of 34 mg daily [1 is not relevant to this answer, a more recent study would be needed to provide this information]. Key points to consider when prescribing Pimavanserin include:
- Regular monitoring for side effects, such as peripheral edema, nausea, and confusion
- Avoiding concomitant use with strong CYP3A4 inhibitors or inducers
- Ensuring adequate hydration and monitoring for signs of orthostatic hypotension
- Common side effects include nausea, peripheral edema, and confusion. It is essential to note that the provided evidence does not support the use of Pimavanserin in the treatment of bipolar disorder in children and adolescents, and its use in this population would be off-label 1.
From the FDA Drug Label
NUPLAZID contains pimavanserin, an atypical antipsychotic, which is present as pimavanserin tartrate salt with the chemical name, urea, N-[(4-fluorophenyl)methyl]-N-(1-methyl-4-piperidinyl)-N'-[[4-(2-methylpropoxy)phenyl]methyl]-,(2R,3R)-2,3-dihydroxybutanedioate (2:1).
Encylextra (Caprylidene) is not mentioned in the provided drug labels. However, Encylexta is another name for Pimavanserin, which is the active ingredient in NUPLAZID 2 2.
- Pimavanserin is an atypical antipsychotic.
- It is used for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis (PDP).
From the Research
Definition and Use of Pimavanserin
- Pimavanserin, also known as Nuplazid, is a medication used to treat hallucinations and delusions associated with Parkinson's disease psychosis (PDP) 3, 4, 5, 6, 7.
- It is a highly selective serotonin 5-HT2A receptor inverse agonist, which means it targets specific receptors in the brain to reduce psychotic symptoms without worsening motor symptoms 5, 7.
Mechanism of Action and Efficacy
- Pimavanserin's mechanism of action is attributed to its selective binding to serotonergic receptors, which helps to reduce psychotic symptoms without affecting dopamine receptors 3, 5.
- Clinical trials have shown that pimavanserin is effective in reducing hallucinations and delusions in patients with PDP, with a number needed to treat (NNT) of 10 6.
- Pimavanserin has also been shown to have a favorable benefit-risk profile, with a likelihood to be helped or harmed (LHH) of approximately 5:1 6.
Comparison to Other Treatments
- Pimavanserin is the only medication approved by the FDA for the treatment of PDP 4, 7.
- Other atypical antipsychotics, such as clozapine and quetiapine, have been used off-label to treat PDP, but they may have significant side effects and are not approved for this indication 3, 4, 5.
- Pimavanserin has been shown to be effective and safe in clinical trials, with a lower risk of worsening motor symptoms and other adverse events compared to other antipsychotics 3, 6, 7.