From the Research
Olanzapine is not recommended for treating Parkinson's disease due to its potential to worsen motor symptoms. According to the most recent and highest quality study, 1, pimavanserin is the only Food and Drug Administration medication approved for the treatment of Parkinson's disease psychosis (PDP) and is considered the first-line treatment for mild psychotic symptoms. Other antipsychotics, such as quetiapine and clozapine, may be used for psychosis that requires improvement in a short period of time, but they should be used with caution due to their potential to worsen motor function. Some key points to consider when treating Parkinson's disease psychosis include:
- The decision to treat psychosis is determined by the severity of the symptoms, impact on quality of life, and tolerance for the treatment.
- Initial management involves a reduction in non-PD psychoactive medications and/or modification of PD medications.
- Pharmacotherapy is primarily limited to atypical antipsychotics and pimavanserin.
- Antipsychotics used to treat PDP should demonstrate safety, motor tolerability, and efficacy over time, as reported in 2 and 1. It is essential to consult with a neurologist who specializes in movement disorders to determine the most appropriate medication that won't compromise motor function, as stated in 1.