Drug updated on 4/26/2024
| Dosage Form | Tablet (oral; 10 mg); Capsule (oral; 34 mg) |
| Drug Class | Atypical antipsychotics |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis.
Summary
- Pimavanserin (Nuplazid) is indicated for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis, standing as a strong alternative to other second-generation antipsychotics by showing significant improvement in psychotic symptoms compared with placebo.
- The information was derived from five systematic reviews/meta-analyses on Pimavanserin (Nuplazid).
- Compared to Clozapine, which was found to be most effective in reducing psychotic symptoms among patients with Parkinson's disease psychosis, Pimavanserin showed comparable efficacy and presented fewer side effects requiring monitoring.
- Pimavanserin has a neutral effect on motor function, making it safer for patients concerned about exacerbating motor symptoms. This contrasts with Quetiapine and Olanzapine, which did not demonstrate significant benefits without worsening motor functions.
- Regarding safety and tolerability, while there is an increased dropout due to adverse events associated with Pimavanserin use, its overall risk profile remains favorable, especially considering its minimal impact on motor function unlike Melperone, which had lower adverse-effect dropout rates but less mention regarding efficacy comparison.
- While specific subgroup considerations were not extensively detailed in the studies reviewed, emphasis consistently pointed towards patients experiencing Parkinson’s disease psychosis where both Clozapine and Pimavanserin are suggested as preferable options due to their minimal impact on motor symptoms.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Nuplazid (pimavanserin) Prescribing Information. | 2023 | Acadia Pharmaceuticals Inc., San Diego, CA |
Systematic Reviews / Meta-Analyses
| Document Title | Year | Source |
|---|---|---|
| Second-generation antipsychotics for Parkinson's disease psychosis: A systematic review and network meta-analysis. | 2024 | General Hospital Psychiatry |
| Comparative efficacy, safety, and acceptability of pimavanserin and other atypical antipsychotics for Parkinson’s disease psychosis: Systematic review and network meta-analysis. | 2023 | Journal of geriatric Psychiatry and Neurology |
| Systematic review on Parkinson’s disease medications, emphasizing on three recently approved drugs to control Parkinson’s symptoms. | 2021 | International Journal of Environmental Research and Public Health |
| Efficacy and safety of atypical antipsychotics for psychosis in Parkinson's disease: A systematic review and Bayesian network meta-analysis. | 2020 | Parkinsonism & Related Disorders |
| Atypical antipsychotics for Parkinson’s disease psychosis: A systematic review and meta-analysis. | 2019 | Neuropsychiatric Disease and Treatment |
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| Canadian guideline for Parkinson disease. | 2019 | CMAJ |