scholarly journals Neurological commentary addressing the article titled “Guidance for switching from off-label antipsychotics to pimavanserin for Parkinson’s disease psychosis: an expert consensus”

CNS Spectrums ◽  
2018 ◽  
Vol 23 (6) ◽  
pp. 352-354
Author(s):  
Neal Hermanowicz

Parkinson’s disease psychosis (PDP) occurs commonly and can comprise the most troubling symptoms among the many that occur with this illness. Prior treatment options for PDP have been limited and unsatisfactory due to uneven efficacy data, burdensome monitoring, and lack of a specific FDA indication coupled with warnings of increased mortality. Pimavanserin, approved for the treatment of PDP by the FDA in 2016, overcomes some of these obstacles, with data proven efficacy and without the frequent monitoring required for clozapine. This presents an opportunity to transition patients with PDP to pimavanserin from older therapies. Black and colleagues provide their thoughtful recommendations on how to achieve this transition to pimavanserin while maintaining symptom control and minimizing disruptions that might occur with a medication change.

CNS Spectrums ◽  
2018 ◽  
Vol 23 (6) ◽  
pp. 355-357
Author(s):  
Leslie Citrome

Pimavanserin is not curative, but can improve the quality of life remaining for the person with Parkinson’s disease who typically has been suffering from this relentless neurodegenerative disease for years. Using pimavanserin effectively requires knowledge not only about the product itself, but also about the treatments pimavanserin is replacing.


CNS Spectrums ◽  
2019 ◽  
Vol 24 (5) ◽  
pp. 574-575
Author(s):  
Kevin J. Black ◽  
Henry Nasrallah ◽  
Stuart Isaacson ◽  
Mark Stacy ◽  
Rajesh Pahwa ◽  
...  

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
T. Foltynie ◽  
C. Magee ◽  
C. James ◽  
G. J. M. Webster ◽  
A. J. Lees ◽  
...  

Treatment options in advanced Parkinson’s disease (PD) include subcutaneous apomorphine, pallidal or subthalamic nucleus Deep Brain Stimulation (DBS), or levodopa/carbidopa intestinal gel (LCIG/Duodopa). In this study, we describe the outcome of 12 PD patients with PD related complications started on LCIG, with respect to their quality of life measured by a disease specific validated scale—the PDQ39, together with diaries recording time spent “On,” “Off,” “Dyskinetic,” or “Asleep.” At the time of latest follow up, improvements were observed in both the PDQ39 Summary index as well as diary reports of PD symptom control following introduction of LCIG, supporting its use in well selected patients. The use of a trial period of LCIG via naso-jejunal administration allows objective evaluation of improvement in PD symptom control in advance of the placement of the more invasive percutaneous jejunostomy procedure. The decision to embark on LCIG, apomorphine or DBS should be supported by input from centres with experience of all 3 approaches. Since LCIG is an expensive option, development of the most appropriate future commissioning of this therapy in the absence of Class 1 evidence requires careful scrutiny of the outcomes of its use in a broad range of published series.


2020 ◽  
Author(s):  
Depanjan Sarkar ◽  
Drupad Trivedi ◽  
Eleanor Sinclair ◽  
Sze Hway Lim ◽  
Caitlin Walton-Doyle ◽  
...  

Parkinson’s disease (PD) is the second most common neurodegenerative disorder for which identification of robust biomarkers to complement clinical PD diagnosis would accelerate treatment options and help to stratify disease progression. Here we demonstrate the use of paper spray ionisation coupled with ion mobility mass spectrometry (PSI IM-MS) to determine diagnostic molecular features of PD in sebum. PSI IM-MS was performed directly from skin swabs, collected from 34 people with PD and 30 matched control subjects as a training set and a further 91 samples from 5 different collection sites as a validation set. PSI IM-MS elucidates ~ 4200 features from each individual and we report two classes of lipids (namely phosphatidylcholine and cardiolipin) that differ significantly in the sebum of people with PD. Putative metabolite annotations are obtained using tandem mass spectrometry experiments combined with accurate mass measurements. Sample preparation and PSI IM-MS analysis and diagnosis can be performed ~5 minutes per sample offering a new route to for rapid and inexpensive confirmatory diagnosis of this disease.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Megan P. Feeney ◽  
Danny Bega ◽  
Benzi M. Kluger ◽  
A. Jon Stoessl ◽  
Christiana M. Evers ◽  
...  

AbstractSymptomatic management of Parkinson’s disease (PD) is complex and many symptoms, especially non-motor symptoms, are not effectively addressed with current medications. In the US, cannabis has become more widely available for medical and recreational use, permitting those in the PD community to try alternative means of symptom control. However, little is known about the attitudes towards, and experiences with, cannabis use among those living with PD. To address this shortcoming, we distributed an anonymous survey to 7,607 people with PD in January 2020 and received 1339 responses (17.6%). 1064 complete responses were available for analysis. Respondents represented 49 states with a mean age of 71.2 years (±8.3) and mean PD duration of 7.4 years (±6.2). About a quarter of respondents (24.5%) reported cannabis use within the previous six months. Age and gender were found to be predictors of cannabis use in this sample (Age OR = 0.95, 95% CI 0.93 to 0.97; Male OR = 1.44, 95% CI 1.03 to 2.03). Users reported learning about cannabis use from the internet/news (30.5%) and friends or other people with PD (26.0%). Cannabis users were more likely to report insufficient control of their non-motor symptoms with prescription medications than non-users (p = 0.03). Cannabis was primarily used for PD (63.6%) and was most often used to treat nonmotor symptoms of anxiety (45.5%), pain (44.0%), and sleep disorders (44.0%). However, nearly a quarter of users (23.0%) also reported they had stopped cannabis use in the previous six months, primarily due to a lack of symptom improvement (35.5%). Three quarters of respondents (75.5%) did not use cannabis, primarily because there was a lack of scientific evidence supporting efficacy (59.9%). Our results suggest that the lack of formal guidance or research evidence about cannabis for PD may in part underlie inconsistencies in both use and reported effectiveness.


2021 ◽  
pp. e35
Author(s):  
Akintomiwa I. Makanjuola ◽  
Funmilola T. Taiwo ◽  
Joseph O. Yaria ◽  
Rufus O. Akinyemi ◽  
Adesola Ogunniyi

Parkinson’s disease (PD) remains a common neurodegenerative movement disorder with significant morbidity, which is expected to increase worldwide in the coming decades. Since its initial description, much has been elucidated about its etiology, pathogenesis, and the role of genetic and environmental risk factors. Effective treatments, including surgical therapies, have been discovered. Despite these strides, many questions remain unanswered; PD remains an active research area with ongoing efforts to discover newer treatment modalities and identify neuroprotective strategies. As with many neurological conditions, there is an unequal distribution of health resources, resulting in some management challenges in low resource settings, especially sub-Saharan Africa (SSA). In this communication, we provide an overview of PD etiopathogenesis, including genetics and management strategies, including some recent advances with respect to treatment options and disease modification approaches. Finally, we discuss some challenges of PD management in low-resource settings and highlight efforts to turn the tide.


Author(s):  
Hayrettin Ozan Gulcan

: Similar to other neurodegenerative diseases, Parkinson’s disease (PD) has been extensively investigated with respect to its neuropathological background and possible treatment options. Since the symptomatic outcomes are generally related to dopamine deficiency, the current treatment strategies towards PD mainly employ dopaminergic agonists as well as the compounds acting on dopamine metabolism. These drugs do not provide disease modifying properties; therefore alternative drug discovery studies focus on targets involved in the progressive neurodegenerative character of PD. This study has aimed to present the pathophysiology of PD concomitant to the representation of drugs and promising molecules displaying activity against the validated and non-validated targets of PD.


BMJ ◽  
1999 ◽  
Vol 319 (7217) ◽  
pp. 1141-1141
Author(s):  
H. Allain

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