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Pimavanserin: Potential Treatment For Dementia-Related Psychosis
J Cummings1, C Ballard, P Tariot
1Jeffrey Cummings MD, ScD, Cleveland Clinic Lou Ruvo Center for Brain Health, 888 W. Bonneville Ave, Las Vegas, NV, USA, cumminj@ccf.org.
The Journal of Prevention of Alzheimer'S Disease
|October 10, 2018
Summary
Pimavanserin shows promise for treating psychosis in dementia, improving symptoms without harming cognition. Ongoing studies evaluate its long-term effectiveness for hallucinations and delusions in neurodegenerative disorders.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Psychosis is prevalent in dementia (20-70%), lacking approved treatments.
- Atypical antipsychotics are used but carry safety concerns.
- Pimavanserin, a 5-HT2A inverse agonist, is approved for Parkinson's disease psychosis (PDP).
Purpose of the Study:
- To evaluate pimavanserin's efficacy and safety for dementia-related psychosis.
- To assess pimavanserin's impact on cognition in patients with cognitive impairment.
- To establish a foundation for ongoing studies in common neurodegenerative disorders.
Main Methods:
- Clinical trials involving patients with Parkinson's disease psychosis (PDP) and Alzheimer's disease psychosis (ADP).
- Assessment using the Scale for the Assessment of Positive Symptoms - Parkinson's disease (SAPS-PD) and NPI-NH Psychosis Score (PS).
- Subgroup analyses for patients with varying degrees of cognitive impairment and psychosis severity.
Main Results:
- Pimavanserin significantly improved psychosis symptoms in PDP (p=0.001) and ADP (p=0.045) versus placebo.
- Cognitive function was not adversely affected in PDP patients with mild cognitive impairment.
- Greater treatment effects were observed in subgroups with higher baseline psychosis scores.
Conclusions:
- Pimavanserin demonstrates efficacy in treating psychosis associated with PDP and ADP.
- The drug appears safe for cognition in impaired patients.
- Results support further investigation of pimavanserin for broader dementia-related psychosis.
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