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Joseph H Friedman - One of the best experts on this subject based on the ideXlab platform.
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Drug Induced Psychosis in parkinson disease phenomenology and correlations among Psychosis rating instruments
Clinical Neuropharmacology, 2005Co-Authors: Kelvin L Chou, Susan Messing, David Oakes, Peter D Feldman, Alan Breier, Joseph H FriedmanAbstract:Objectives: To describe further the phenomenology of Drug-Induced Psychosis (DIP) in patients with Parkinson disease (PD) and assess which items on two common Psychosis rating instruments-the Brief Psychiatric Rating Scale (BPRS) and the Neuropsychiatric Inventory (NPI)-are the best measure of DIP by comparing them with the Clinical Global Impression Scale (CGIS). Methods: Baseline data from two placebo-controlled, double-blind studies of olanzapine in PD patients with DIP were collected and analyzed. Results: A total of 157 of 160 patients had hallucinations, with visual hallucinations being the most common (97% of subjects), followed by auditory (48%), tactile (23%), and olfactory (16%). Seventy-six percent of subjects experienced delusions, and all types of delusions occurred with relatively equal frequency. The CGIS correlated with suspiciousness, hallucinatory behavior, unusual thought content, and hostility on the BPRS; and delusions, hallucinations, agitation, aberrant motor behavior, and sleep on the NPI. Conclusion: Nonvisual hallucinations and delusions may occur more frequently in DIP than previously thought. These symptoms, plus agitation and hostility, may ultimately be the best measure of DIP in patients with PD.
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aripiprazole for Drug Induced Psychosis in parkinson disease preliminary experience
Clinical Neuropharmacology, 2004Co-Authors: Hubert H Fernandez, Martha E Trieschmann, Joseph H FriedmanAbstract:Abstract Aripiprazole is the newest atypical antipsychotic (AA) Drug to be released in the US. It is the only AA that is a partial agonist at the D2 and 5HT1a receptors and an antagonist at 5HT2a receptors. It also has a high 5HT2/D2 ratio and may therefore carry a low risk of extrapyramidal side effects and alleviate Psychosis in Parkinson-vulnerable populations. We report our preliminary experience in 8 patients with probable Parkinson disease (PD) treated with aripiprazole for Drug-Induced Psychosis. Two patients were neuroleptic-naive, 5 patients were "quetiapine failures", and 1 patient was switched from olanzapine to aripiprazole. Aripiprazole was started at 5 mg to 10 mg a day and slowly increased over 3 to 7 days until side effects or improvement of Psychosis occurred. Only 2 out of 8 patients experienced near complete resolution of their Psychosis using aripiprazole. The other six patients discontinued aripiprazole within 40 days, 2 of whom discontinued due to motor worsening. Our preliminary experience with aripiprazole is mixed but not very encouraging. Controlled studies are needed to evaluate aripiprazole in parkinsonian patients.
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clozapine for the treatment of Drug Induced Psychosis in parkinson s disease results of the 12 week open label extension in the psyclops trial
Movement Disorders, 2001Co-Authors: Stewart A Factor, Joseph H Friedman, David Oakes, Margaret C Lannon, Keith BourgeoisAbstract:OBJECTIVE: To report the results of the 12-week, prospective, open label extension of the 4-week, multicenter, placebo-controlled, double-blind PSYCLOPS (Psychosis and CLOzapine in the treatment of Parkinsonism) trial. This extension examined the chronic safety and efficacy of clozapine in the treatment of Drug-Induced Psychosis in Parkinson's disease (PD). BACKGROUND: Psychosis is a serious late complication of PD and may be a harbinger to increased mortality. Clozapine, the first atypical antipsychotic, was shown in several small open label studies to improve Psychosis without worsening of motor symptoms. This was recently confirmed in the double-blind PSYCLOPS trial. METHODS: The 53 patients who completed the double-blind portion of PSYCLOPS were evaluated on their original randomized treatment (clozapine or placebo), then had study medication stopped. All were started on clozapine. The patients from both treatment groups were evaluated every 4 weeks over a 12-week period using standardized measures for Psychosis and PD. RESULTS: The mean dose of clozapine was 28.78 mg/day. Those originally treated with placebo improved significantly in Brief Psychiatric Rating Scale and clinical global scores for Psychosis to the same degree as the group originally randomized to clozapine in the double-blind study. Both groups maintained their response to week 16 (end of the combined double-blind and open label portions). There was no worsening of motor features as measured by the Unified Parkinson's disease rating scale. Eighteen patients were either hospitalized or died during the trial. The most common reasons were pulmonary. CONCLUSIONS: Low-dose clozapine is effective in treating Drug-Induced Psychosis without worsening motor features of PD, and the response is maintained for at least 4 months. Patients with Psychosis and PD were previously described as a group with high risk for morbidity and mortality. The high risk continues despite antipsychotic therapy.
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atypical antipsychotics in the treatment of Drug Induced Psychosis in parkinson s disease
Movement Disorders, 2000Co-Authors: Joseph H Friedman, Stewart A FactorAbstract:: Our experience with atypical antipsychotics in patients with PD is that their motor effects are not predictable. The multiple reports concerning clozapine's beneficial effects on tremor, dystonia, nocturnal akathisia, and dyskinesias all underscore this observation. However, the appearance of even minor degrees of parkinsonism in normal volunteers or schizophrenics should suggest that an antipsychotic will not be well-tolerated in patients with PD. The treatment of PD is probably the most stringent test of a Drug's freedom from parkinsonian side effects. The data from trials in schizophrenia concerning parkinsonian effects cannot always be confidently interpreted. Virtually all subjects in these trials have been treated with typical neuroleptics until shortly before study entry. Because the parkinsonian side effects of these Drugs may persist for several months, patients may still show declining levels of parkinsonism even when placed on a Drug that induces it if this effect is milder than that Induced by the pre-study neuroleptic. Depending on the pre-study Drug used and the duration of the study, distinguishing placebo from a low-potency neuroleptic may be impossible. Furthermore, the standard measure of parkinsonism in psychiatric studies is the Simpson-Angus scale which is heavily weighted toward rigidity and may underscore bradykinesia, gait, and posture abnormalities. The prolactin response to an antipsychotic Drug may turn out to be a good predictor of its freedom from parkinsonian side effects. That would fit with the data presented above of clozapine and quetiapine having less parkinsonian effects, olanzapine having more but variable effects and risperidone being poorly tolerated. With the data presented above, comprising a current review of all reports of the use of atypical antipsychotics in PD that we could locate, we can say little with certainty. The only Drug with confirmed benefit without worsening parkinsonism is clozapine. Open-label trials involving over 400 patients and two multicenter, placebo-controlled, double-blind trials have demonstrated that it is effective in treating the Psychosis. It improves tremor, does not worsen other motor functions to any significant extent, and is safe at low doses. Limited data provide conflicting information on both risperidone and olanzapine. Quetiapine seems to be well-tolerated with some, but definitely less, worsening of PD motor features than risperidone and olanzapine. Based on the current literature, our personal experience, and anecdotal experience of other PD specialists which we solicited, we will venture our own interpretation and recommendations. We think risperidone is poorly tolerated and should be used only as a last resort; that olanzapine is better than risperidone but will, in a majority of patients with PD, worsen motor function. We are optimistic, but not yet convinced, that quetiapine may prove to be as effective and better tolerated than clozapine. It will not require cumbersome monitoring because it does not induce a blood dyscrasia. We therefore recommend that DP be treated in the following manner. First, the anti-PD medications should be simplified and reduced as much as tolerated. We think, in general, side effects multiply more with increasing numbers of Drugs than with Drug dose, so that patients are more likely to tolerate a higher dose of levodopa than a lower dose of levodopa combined with other adjunctive anti-PD medications. In reducing anti-PD medications, we recommend tapering and stopping, if necessary, the Drugs with the highest risk-to-benefit ratio first. Anticholinergics are stopped first, then selegiline, dopamine agonists, amantadine, and finally COMT inhibitors, which have no psychotomimetic action of their own. Finally, levodopa is reduced. Generally, a point is reached at which the anti-PD medications cannot be reduced without jeopardizing motor function. If Psychosis persists at this point, then an antipsychotic is added. (ABS
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quetiapine for the treatment of Drug Induced Psychosis in parkinson s disease
Movement Disorders, 1999Co-Authors: Hubert H Fernandez, Joseph H Friedman, Carol Jacques, Michael RosenfeldAbstract:: Quetiapine is an atypical antipsychotic with clozapine-like pharmacology but without associated agranulocytosis. We report our complete experience with quetiapine for the treatment of Drug-Induced Psychosis (DIP) in Parkinson's disease (PD). Thirty-five patients with PD and DIP aged 75 years (range, 58-89) with a mean PD duration of 8.4 years on an average of 427 mg levodopa per day received a mean dose of 40.6 mg quetiapine daily. Twenty of 24 neuroleptic-naive patients reported marked improvement of Psychosis without a decline in motor function as assessed by the Unified Parkinson's Disease Rating Scale (UPDRS-motor). Ten patients had a baseline and 4-week follow-up assessment using the Mini-Mental Status Examination (MMSE) and Brief Psychiatric Rating Scale (BPRS). The improvement in BPRS score (32.6 versus 22.8) was clinically and statistically significant (p = 0.024). Three of 24 were unable to tolerate quetiapine because of orthostatic hypotension, headache, nausea, and persistence of hallucinations. One patient died of an unrelated cause. We also tried to switch 11 psychiatrically stable patients on clozapine (eight) and olanzapine (three). Five patients made this transition without a loss of effect as measured on BPRS and MMSE. Six did not (five on clozapine, one on olanzapine) because of confusion, erratic behavior, and increased hallucinations. No crossover failure had worsened PD except for increased tremor in one. Quetiapine is useful and well-tolerated as a first Drug to treat DIP in PD but must be used cautiously to replace other atypical antipsychotic Drugs.
Stewart A Factor - One of the best experts on this subject based on the ideXlab platform.
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parkinson s disease the treatment of Drug Induced hallucinations and Psychosis
Current Neurology and Neuroscience Reports, 2001Co-Authors: Eric Molho, Stewart A FactorAbstract:Drug-Induced Psychosis is one of the most disabling complications of advancing Parkinson’s disease. It has also been one of the most difficult to treat. Clozapine was the first medication shown to be safe and effective in this setting, and it remains the standard by which newer atypical antipsychotics are measured. However, due to the small but significant risk of agranulocytosis and the need for frequent blood testing, alternatives have been sought. Risperidone, olanzapine, and quetiapine are new atypical antipsychotics that have each been proposed as an alternative to clozapine, but the literature concerning their use in Parkinson’s disease is conflicted and confusing. Although quetiapine appears to be the best current choice, none of these medications have equaled clozapine’s ability to safely treat Drug-Induced Psychosis without the risk of worsening parkinsonism.
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Parkinson’s disease: The treatment of Drug-Induced hallucinations and Psychosis
Current Neurology and Neuroscience Reports, 2001Co-Authors: Eric Molho, Stewart A FactorAbstract:Drug-Induced Psychosis is one of the most disabling complications of advancing Parkinson’s disease. It has also been one of the most difficult to treat. Clozapine was the first medication shown to be safe and effective in this setting, and it remains the standard by which newer atypical antipsychotics are measured. However, due to the small but significant risk of agranulocytosis and the need for frequent blood testing, alternatives have been sought. Risperidone, olanzapine, and quetiapine are new atypical antipsychotics that have each been proposed as an alternative to clozapine, but the literature concerning their use in Parkinson’s disease is conflicted and confusing. Although quetiapine appears to be the best current choice, none of these medications have equaled clozapine’s ability to safely treat Drug-Induced Psychosis without the risk of worsening parkinsonism.
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clozapine for the treatment of Drug Induced Psychosis in parkinson s disease results of the 12 week open label extension in the psyclops trial
Movement Disorders, 2001Co-Authors: Stewart A Factor, Joseph H Friedman, David Oakes, Margaret C Lannon, Keith BourgeoisAbstract:OBJECTIVE: To report the results of the 12-week, prospective, open label extension of the 4-week, multicenter, placebo-controlled, double-blind PSYCLOPS (Psychosis and CLOzapine in the treatment of Parkinsonism) trial. This extension examined the chronic safety and efficacy of clozapine in the treatment of Drug-Induced Psychosis in Parkinson's disease (PD). BACKGROUND: Psychosis is a serious late complication of PD and may be a harbinger to increased mortality. Clozapine, the first atypical antipsychotic, was shown in several small open label studies to improve Psychosis without worsening of motor symptoms. This was recently confirmed in the double-blind PSYCLOPS trial. METHODS: The 53 patients who completed the double-blind portion of PSYCLOPS were evaluated on their original randomized treatment (clozapine or placebo), then had study medication stopped. All were started on clozapine. The patients from both treatment groups were evaluated every 4 weeks over a 12-week period using standardized measures for Psychosis and PD. RESULTS: The mean dose of clozapine was 28.78 mg/day. Those originally treated with placebo improved significantly in Brief Psychiatric Rating Scale and clinical global scores for Psychosis to the same degree as the group originally randomized to clozapine in the double-blind study. Both groups maintained their response to week 16 (end of the combined double-blind and open label portions). There was no worsening of motor features as measured by the Unified Parkinson's disease rating scale. Eighteen patients were either hospitalized or died during the trial. The most common reasons were pulmonary. CONCLUSIONS: Low-dose clozapine is effective in treating Drug-Induced Psychosis without worsening motor features of PD, and the response is maintained for at least 4 months. Patients with Psychosis and PD were previously described as a group with high risk for morbidity and mortality. The high risk continues despite antipsychotic therapy.
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atypical antipsychotics in the treatment of Drug Induced Psychosis in parkinson s disease
Movement Disorders, 2000Co-Authors: Joseph H Friedman, Stewart A FactorAbstract:: Our experience with atypical antipsychotics in patients with PD is that their motor effects are not predictable. The multiple reports concerning clozapine's beneficial effects on tremor, dystonia, nocturnal akathisia, and dyskinesias all underscore this observation. However, the appearance of even minor degrees of parkinsonism in normal volunteers or schizophrenics should suggest that an antipsychotic will not be well-tolerated in patients with PD. The treatment of PD is probably the most stringent test of a Drug's freedom from parkinsonian side effects. The data from trials in schizophrenia concerning parkinsonian effects cannot always be confidently interpreted. Virtually all subjects in these trials have been treated with typical neuroleptics until shortly before study entry. Because the parkinsonian side effects of these Drugs may persist for several months, patients may still show declining levels of parkinsonism even when placed on a Drug that induces it if this effect is milder than that Induced by the pre-study neuroleptic. Depending on the pre-study Drug used and the duration of the study, distinguishing placebo from a low-potency neuroleptic may be impossible. Furthermore, the standard measure of parkinsonism in psychiatric studies is the Simpson-Angus scale which is heavily weighted toward rigidity and may underscore bradykinesia, gait, and posture abnormalities. The prolactin response to an antipsychotic Drug may turn out to be a good predictor of its freedom from parkinsonian side effects. That would fit with the data presented above of clozapine and quetiapine having less parkinsonian effects, olanzapine having more but variable effects and risperidone being poorly tolerated. With the data presented above, comprising a current review of all reports of the use of atypical antipsychotics in PD that we could locate, we can say little with certainty. The only Drug with confirmed benefit without worsening parkinsonism is clozapine. Open-label trials involving over 400 patients and two multicenter, placebo-controlled, double-blind trials have demonstrated that it is effective in treating the Psychosis. It improves tremor, does not worsen other motor functions to any significant extent, and is safe at low doses. Limited data provide conflicting information on both risperidone and olanzapine. Quetiapine seems to be well-tolerated with some, but definitely less, worsening of PD motor features than risperidone and olanzapine. Based on the current literature, our personal experience, and anecdotal experience of other PD specialists which we solicited, we will venture our own interpretation and recommendations. We think risperidone is poorly tolerated and should be used only as a last resort; that olanzapine is better than risperidone but will, in a majority of patients with PD, worsen motor function. We are optimistic, but not yet convinced, that quetiapine may prove to be as effective and better tolerated than clozapine. It will not require cumbersome monitoring because it does not induce a blood dyscrasia. We therefore recommend that DP be treated in the following manner. First, the anti-PD medications should be simplified and reduced as much as tolerated. We think, in general, side effects multiply more with increasing numbers of Drugs than with Drug dose, so that patients are more likely to tolerate a higher dose of levodopa than a lower dose of levodopa combined with other adjunctive anti-PD medications. In reducing anti-PD medications, we recommend tapering and stopping, if necessary, the Drugs with the highest risk-to-benefit ratio first. Anticholinergics are stopped first, then selegiline, dopamine agonists, amantadine, and finally COMT inhibitors, which have no psychotomimetic action of their own. Finally, levodopa is reduced. Generally, a point is reached at which the anti-PD medications cannot be reduced without jeopardizing motor function. If Psychosis persists at this point, then an antipsychotic is added. (ABS
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combined clozapine and electroconvulsive therapy for the treatment of Drug Induced Psychosis in parkinson s disease
Journal of Neuropsychiatry and Clinical Neurosciences, 1995Co-Authors: Stewart A Factor, Eric Molho, Diane L BrownAbstract:: Drug-Induced Psychosis is a serious late complication of Parkinson's disease (PD) that requires aggressive treatment. Recent studies have found clozapine a highly effective and ECT a possibly useful intervention. Two cases are presented that illustrate a possible treatment role for ECT. The cases demonstrate that ECT has significant but short-lived antipsychotic effects when used alone. However, patients who do not respond to clozapine monotherapy can be given adjunctive treatment with ECT. The combination therapy resulted in abrupt alleviation of psychotic symptoms in one of the cases, and maintenance with low-dose clozapine allowed for long-term efficacy. On the basis of these findings, a therapeutic approach to patients with Drug-Induced Psychosis in PD is suggested.
Hubert H Fernandez - One of the best experts on this subject based on the ideXlab platform.
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Combating Psychosis in Parkinson’s disease patients: the use of antipsychotic Drugs
Expert Opinion on Investigational Drugs, 2006Co-Authors: Kelvin L Chou, Hubert H FernandezAbstract:Parkinson’s disease (PD) patients commonly experience psychotic symptoms, with the most frequent manifestation being visual hallucinations. In PD, Psychosis is predominantly Drug Induced and an important issue for clinicians to address as it increases the risk of nursing home placement as well as mortality. This review summarises the current knowledge regarding the clinical manifestations, pathophysiology and risk factors for Drug-Induced Psychosis in patients with PD and focuses on treatment, especially with regard to the atypical antipsychotics.
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Rebound Psychosis: Effect of discontinuation of antipsychotics in Parkinson's disease
Movement Disorders, 2004Co-Authors: Hubert H Fernandez, Martha E Trieschmann, Michael S. OkunAbstract:To determine whether psychiatrically stable patients with a history of Drug-Induced Psychosis could be successfully weaned off their antipsychotic Drug, we offered consecutive Parkinson disease (PD) patients on quetiapine or clozapine, who were free of any on-going Psychosis, to be slowly weaned off their antipsychotic Drug. Before the study was aborted 6 PD patients (mean age, 78 years) with an average antipsychotic exposure of 20 months (5 on quetiapine, 1 on clozapine) were enrolled. After the antipsychotic agent was discontinued, Psychosis recurred in 5 of 6 patients. In 3 patients the “rebound Psychosis” was worse than the original psychotic episode and required subsequent higher antipsychotic medication doses. © 2004 Movement Disorder Society
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aripiprazole for Drug Induced Psychosis in parkinson disease preliminary experience
Clinical Neuropharmacology, 2004Co-Authors: Hubert H Fernandez, Martha E Trieschmann, Joseph H FriedmanAbstract:Abstract Aripiprazole is the newest atypical antipsychotic (AA) Drug to be released in the US. It is the only AA that is a partial agonist at the D2 and 5HT1a receptors and an antagonist at 5HT2a receptors. It also has a high 5HT2/D2 ratio and may therefore carry a low risk of extrapyramidal side effects and alleviate Psychosis in Parkinson-vulnerable populations. We report our preliminary experience in 8 patients with probable Parkinson disease (PD) treated with aripiprazole for Drug-Induced Psychosis. Two patients were neuroleptic-naive, 5 patients were "quetiapine failures", and 1 patient was switched from olanzapine to aripiprazole. Aripiprazole was started at 5 mg to 10 mg a day and slowly increased over 3 to 7 days until side effects or improvement of Psychosis occurred. Only 2 out of 8 patients experienced near complete resolution of their Psychosis using aripiprazole. The other six patients discontinued aripiprazole within 40 days, 2 of whom discontinued due to motor worsening. Our preliminary experience with aripiprazole is mixed but not very encouraging. Controlled studies are needed to evaluate aripiprazole in parkinsonian patients.
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quetiapine for the treatment of Drug Induced Psychosis in parkinson s disease
Movement Disorders, 1999Co-Authors: Hubert H Fernandez, Joseph H Friedman, Carol Jacques, Michael RosenfeldAbstract:: Quetiapine is an atypical antipsychotic with clozapine-like pharmacology but without associated agranulocytosis. We report our complete experience with quetiapine for the treatment of Drug-Induced Psychosis (DIP) in Parkinson's disease (PD). Thirty-five patients with PD and DIP aged 75 years (range, 58-89) with a mean PD duration of 8.4 years on an average of 427 mg levodopa per day received a mean dose of 40.6 mg quetiapine daily. Twenty of 24 neuroleptic-naive patients reported marked improvement of Psychosis without a decline in motor function as assessed by the Unified Parkinson's Disease Rating Scale (UPDRS-motor). Ten patients had a baseline and 4-week follow-up assessment using the Mini-Mental Status Examination (MMSE) and Brief Psychiatric Rating Scale (BPRS). The improvement in BPRS score (32.6 versus 22.8) was clinically and statistically significant (p = 0.024). Three of 24 were unable to tolerate quetiapine because of orthostatic hypotension, headache, nausea, and persistence of hallucinations. One patient died of an unrelated cause. We also tried to switch 11 psychiatrically stable patients on clozapine (eight) and olanzapine (three). Five patients made this transition without a loss of effect as measured on BPRS and MMSE. Six did not (five on clozapine, one on olanzapine) because of confusion, erratic behavior, and increased hallucinations. No crossover failure had worsened PD except for increased tremor in one. Quetiapine is useful and well-tolerated as a first Drug to treat DIP in PD but must be used cautiously to replace other atypical antipsychotic Drugs.
Karla Eggert - One of the best experts on this subject based on the ideXlab platform.
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development and evaluation of the parkinson Psychosis questionnaire a screening instrument for the early diagnosis of Drug Induced Psychosis in parkinson s disease
Journal of Neurology, 2005Co-Authors: D Brandstaedter, S Spieker, Uwe Siebert, T Eichhorn, Jurgenchristian Krieg, Wolfgang H Oertel, Karla EggertAbstract:Objective Drug-Induced Psychosis is a frequent side–effect in the treatment of advanced Parkinson’s disease (PD). We sought to develop and evaluate a brief instrument for early recognition of Drug–Induced Psychosis in PD.
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Development and evaluation of the Parkinson Psychosis Questionnaire
Journal of Neurology, 2005Co-Authors: D Brandstaedter, S Spieker, Uwe Siebert, T Eichhorn, Jurgenchristian Krieg, Wolfgang H Oertel, Karla EggertAbstract:Objective Drug-Induced Psychosis is a frequent side–effect in the treatment of advanced Parkinson’s disease (PD). We sought to develop and evaluate a brief instrument for early recognition of Drug–Induced Psychosis in PD.
Erich Mohr - One of the best experts on this subject based on the ideXlab platform.
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Drug-Induced Psychosis in Parkinson’s Disease
CNS Drugs, 1996Co-Authors: Tilak Mendis, C. Lynn Barclay, Erich MohrAbstract:Drug-Induced Psychosis represents one of the more serious adverse effects of therapy for Parkinson’s disease. Risk factors include dementia, a history of psychiatric illness, advancing age, and the dose and duration of treatment with dopamine-enhancing agents. The pathophysiological basis of Drug-Induced Psychosis has not been established. Chronic changes in both the dopaminergic and serotonergic systems have been implicated in producing these symptoms. Management options include the reduction and/or elimination of medications used for symptomatic control of the illness. However, with the attendant risks of an unacceptable reduction in mobility and, in rare cases, life-threatening complications, therapeutic alternatives are required. Treatment with atypical antipsychotic agents, such as clozapine and risperidone, presents such an avenue. Nonpharmacological treatments, including electroconvulsive therapy (ECT), may also play a role in the management of these patients.
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Drug-Induced Psychosis in Parkinson’s Disease
CNS Drugs, 1996Co-Authors: Tilak Mendis, C. Lynn Barclay, Erich MohrAbstract:Drug-Induced Psychosis represents one of the more serious adverse effects of therapy for Parkinson’s disease. Risk factors include dementia, a history of psychiatric illness, advancing age, and the dose and duration of treatment with dopamine-enhancing agents.
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Drug Induced Psychosis in parkinson s disease
CNS Drugs, 1996Co-Authors: Tilak Mendis, Lynn C Barclay, Erich MohrAbstract:Drug-Induced Psychosis represents one of the more serious adverse effects of therapy for Parkinson’s disease. Risk factors include dementia, a history of psychiatric illness, advancing age, and the dose and duration of treatment with dopamine-enhancing agents.
