Antipsychotic Drugs May Increase Risk of Death Among Parkinson’s Disease Psychosis Patients

Findings from a recent study published in the journal JAMDA demonstrate that antipsychotic medications increase the risk of death in patients with Parkinson’s disease psychosis (PDP).

In the study entitled “Impact of Current Antipsychotic Medications on Comparative Mortality and Adverse Events in People With Parkinson Disease Psychosis”, a team of researchers led by Professor Clive Ballard from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London in the United Kingdom, examined a total of 459 patients with PDP aged between 30 and 80 years. All patients had a diagnosis of idiopathic Parkinson disease and moderate to severe psychosis.

Patients were categorized into 2 groups: those receiving concomitant antipsychotic medications and those who did not take antipsychotic medications at any time during the study. Participants were receiving 40 mg pimavanserin daily in addition to concurrent antipsychotics and medications for their Parkinson disease.

The results revealed that after three to six months of treatment, PDP patients treated with antipsychotics were four times more likely to die compared with those who did not receive any antipsychotic agents. The results also showed that the PDP patients were more likely to experience serious health problems such as stroke, infections, falls, cognitive decline and worsening of their Parkinson’s disease symptoms.

Parkinson’s disease (PD) is characterised by progressive cognitive impairment, psychiatry symptoms and loss of motor function, affecting roughly 7-10 million people worldwide. Psychosis, usually characterized by hallucinations and delusions is a distressing and common group of psychiatric symptoms affecting people with PD.

PDP occurs in about 50% of patients with PD at some point during the course of their disease. Antipsychotic drugs are used to treat psychosis associated with PD, however there is a lack of evidence to support their use in standard care.

Professor Clive Ballard from the Wolfson Centre for Age-Related Diseases at the IoPPN, King’s College London, stated in a recent news release, “Our findings clearly indicate serious risks associated with antipsychotics and highlight the need for greater caution in treating psychosis in Parkinson’s disease. Antipsychotics are known to be linked to serious harm in people with Alzheimer’s Disease, and these findings show that a similar, although not identical, risk is seen in people with Parkinson’s. Our findings therefore strongly suggest that doctors, patients and family members should consider these risks very carefully when considering potential treatments for psychosis and any other behavioural symptom in people with Parkinson’s Disease, such as agitation or aggression. Further research is required to develop new, better treatments for psychosis and other behavioural symptoms.”

Professor Ballard added, “For example, a study we published last year showed that a novel antipsychotic, pimavanserin, was effective and had far fewer side effects than traditional antipsychotics.”