Symptomatic relief from treatment-induced psychosis in Parkinson's disease: An open-label pilot study with remoxipride

Authors

  • Dr. Tilak Mendis,

    Corresponding author
    1. Institute of Mental Health Research, Ottawa, Ontario, Canada
    2. Parkinson's Disease Clinic, Ottawa Civic Hospital, Ottawa, Ontario, Canada
    • Institute of Mental Health Research, Royal Ottawa Hospital and University of Ottawa, 1145 Carling Avenue, Ottawa, Ontario, Canada, K1Z 7K4
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  • Erich Mohr,

    1. Institute of Mental Health Research, Ottawa, Ontario, Canada
    2. Parkinson's Disease Clinic, Ottawa Civic Hospital, Ottawa, Ontario, Canada
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  • Amanda George,

    1. Loeb Institute for Medical Research, University of Ottawa, Ottawa, Ontario, Canada
    2. Parkinson's Disease Clinic, Ottawa Civic Hospital, Ottawa, Ontario, Canada
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  • Ilene N. Rusk,

    1. Institute of Mental Health Research, Ottawa, Ontario, Canada
    2. Parkinson's Disease Clinic, Ottawa Civic Hospital, Ottawa, Ontario, Canada
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  • Peggy Gray,

    1. Parkinson's Disease Clinic, Ottawa Civic Hospital, Ottawa, Ontario, Canada
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  • J. David Grimes

    1. Loeb Institute for Medical Research, University of Ottawa, Ottawa, Ontario, Canada
    2. Parkinson's Disease Clinic, Ottawa Civic Hospital, Ottawa, Ontario, Canada
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Abstract

Current treatment strategies for levodopa-induced psychosis in Parkinson's disease have had limited success. Remoxipride, a selective D2 receptor antagonist, was administered in an open label pilot study to seven parkinsonian patients exhibiting thought disorder. Symptoms improved significantly in six patients after treatment durations of 1–6 months and cleared completely in two individuals. One patient (at age 90 the oldest in the group) could not tolerate the compound due to significant motor deterioration, and the drug had to be discontinued after 1 week. In all remaining patients, no motor complications appeared, and therapeutic effects of remoxipride continued for up to 3 months after treatment cessation and have lasted for 2 years now in one individual. Further study of this compound in the context of treatment-induced psychosis in Parkinson's disease appears to be warranted.

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