Long-term outcome of quetiapine use for psychosis among parkinsonian patients

Authors

  • Hubert H. Fernandez MD,

    Corresponding author
    1. Department of Clinical Neurosciences, Brown University School of Medicine, Providence, Rhode Island, USA
    • Division of Neurology, Memorial Hospital of Rhode Island, 111 Brewster Street, Pawtucket, RI 02860
    Search for more papers by this author
    • Hubert H. Fernandez, MD, has, over the past 3 years, been a paid consultant, speaker or carried out clinical research under contract with: Astra-Zeneca, Aventis, Novartis, Teva, Glaxo Smith Klein, Elan, Mylan, and Cephalon, Inc.

  • Martha E. Trieschmann MD,

    1. Department of Clinical Neurosciences, Brown University School of Medicine, Providence, Rhode Island, USA
    Search for more papers by this author
  • Monica A. Burke DO,

    1. Department of Clinical Neurosciences, Brown University School of Medicine, Providence, Rhode Island, USA
    Search for more papers by this author
  • Carol Jacques RNP,

    1. Department of Clinical Neurosciences, Brown University School of Medicine, Providence, Rhode Island, USA
    Search for more papers by this author
  • Joseph H. Friedman MD

    1. Department of Clinical Neurosciences, Brown University School of Medicine, Providence, Rhode Island, USA
    Search for more papers by this author
    • Joseph H. Friedman, MD, has, over the past 5 years, been a paid consultant, speaker or carried out clinical research under contract with: Astra-Zeneca, Aventis, Boehringer-Ingleheim, Bristol-Meyers-Squibb, Eli Lilly, Merck, Novartis, Pfizer, PPD Development, Teva, Pharmacia, and Jannsen.


Abstract

To evaluate the long-term efficacy and tolerability of quetiapine for psychosis among parkinsonian patients, a retrospective analysis of all parkinsonian patients taking quetiapine for psychosis in a single movement disorders center was carried out. Demographic data, including type and severity of psychosis, presence of dementia, treatment response, before and after Unified Parkinson's Disease Rating Scale (UPDRS)-motor scores and Hoehn and Yahr (H&Y) scale were obtained. One hundred six parkinsonian patients with a mean age of 76.6 years were on an average levodopa (L-dopa) dose of 415 mg/d. Seventy-eight of 106 (74%) remained on quetiapine for a mean duration of 15 months at an average dose of 60 mg per day. Eighty-seven (82%) patients had partial or complete resolution of their psychosis whereas 19 (18%) patients had no improvement on quetiapine. Motor worsening was noted in 34 (32%) patients but was uncommonly sufficient to warrant quetiapine discontinuation. More quetiapine non-responders were noted to be demented, delusional, and experienced threatening psychosis but only the presence of dementia remained significant on multivariate analysis (OR = 11.6; 95% CI = 1.4–92.9). Also, patients who developed motor worsening while on quetiapine tended to be more demented (P = 0.07). © 2003 Movement Disorder Society

Ancillary