Risperidone in the treatment of dopamine-induced psychosis in Parkinson's disease: An open pilot trial
Article first published online: 17 JAN 2001
Copyright © 2000 Movement Disorder Society
Volume 15, Issue 6, pages 1230–1237, November 2000
How to Cite
Mohr, E., Mendis, T., Hildebrand, K. and De Deyn, P. P. (2000), Risperidone in the treatment of dopamine-induced psychosis in Parkinson's disease: An open pilot trial. Mov. Disord., 15: 1230–1237. doi: 10.1002/1531-8257(200011)15:6<1230::AID-MDS1026>3.0.CO;2-9
- Issue published online: 17 JAN 2001
- Article first published online: 17 JAN 2001
- Manuscript Revised: 9 MAY 2000
- Manuscript Accepted: 9 MAY 2000
- Manuscript Received: 28 SEP 1999
- Parkinson's disease;
- Extrapyramidal symptoms
To evaluate the safety and efficacy of risperidone in patients with Parkinson's disease (PD) who are experiencing significant dopamine-induced psychosis.
PATIENTS AND METHODS
Seventeen patients (median age, 72 yrs) participated in this 12-week, open pilot study receiving 0.5 to 3 mg oral risperidone per day. Maintenance antiparkinsonian medication was continued throughout, although psychotropic medication was discontinued.
Risperidone produced a substantial improvement in psychotic symptoms, shown on the mean total positive subscale score on the Positive and Negative Syndrome Scale (PANSS) by a 30% improvement (−3.1 decrease) after 1 week and a 66% improvement (−6.8 decrease) at end point. This improvement was most evident in the items delusions, hallucinatory behavior, and suspiciousness/persecution. Risperidone also achieved significant improvement from baseline in Clinical Global Impression (CGI)-severity and CGI-improvement (p <0.001, Page test). Risperidone treatment did not adversely affect symptoms specific to Parkinson's disease, as assessed by the Unified Parkinson's Disease Rating Scale (UPDRS).
Sixteen patients reported at least one adverse event, but only two patients withdrew as a result of adverse events. No significant changes or clinically relevant abnormalities were observed in laboratory parameters or vital signs.
Short-term use of risperidone (mean dosage, 1.1 mg per day) improves the psychopathology of patients with PD who have dopamine-induced psychosis without adversely affecting the symptoms of PD. Higher doses and long-term use were not addressed in this study and may be precluded by extrapyramidal side effects.