To compare the safety and efficacy of quetiapine
for the treatment of psychosis
in patients with Parkinson's disease
Twenty-seven patients with PD and recent-onset psychosis
were randomly allocated to 2 arms of 22 weeks' treatment with quetiapine
after 2 weeks of adjustment of antiparkinsonian medications. Assessment was done by a blinded neuropsychologist using the Clinical Global Impression of Change (CGIC) questionnaire and the Neuropsychiatric Inventory (NPI). Mixed-effect models were used to compare CGIC and Neuropsychological Inventory scores over time between the 2 groups.
Both drugs were equally effective based on the CGIC. Clozapine
had a trend over quetiapine
in controlling the frequency of hallucinations
= 0.097) and a significant advantage in reducing delusions (P
= 0.011). However, one patient in the clozapine
arm developed leukopenia. None of the drugs worsened parkinsonism.
are effective atypical neuroleptics for the treatment of psychotic symptoms in PD. Clozapine
had greater efficacy in reducing hallucinations
and delusions frequency, but its use is associated with an increased risk of leukopenia.