Quetiapine for Psychosis in Parkinson's Disease Versus Dementia With Lewy Bodies
J Clin Psychiatry 2002;63(6):513-515
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Most clinicians perceive
psychosis in dementia with Lewy bodies (DLB) as more difficult to treat than Parkinson's
disease, yet there are no reports comparing the
antipsychotic response between the 2 disorders.
Method: All charts of Parkinson's disease
and DLB patients at our Movement Disorders Center, Memorial Hospital of Rhode Island,
Pawtucket, given quetiapine for psychosis were
reviewed. Demographic data, including type and severity
of psychosis, before and after Unified Parkinson's Disease Rating Scale (UPDRS)-motor
scores, motor worsening, and treatment response
(recorded as poor/none, partial, or total), were
obtained. The chi-square test was used to assess differences in efficacy and tolerability of
quetiapine between Parkinson's disease and DLB patients.
Results: Eighty-seven Parkinson's disease
and 11 DLB patients with psychosis were analyzed. No significant difference in mean age,
levodopa dose, quetiapine dose, duration of quetiapine
use, or baseline UPDRS-motor score was noted between Parkinson's disease and DLB
patients. Eighty percent (70/87) of Parkinson's
disease patients and 90% (10/11) of DLB patients
had partial to complete resolution of psychosis
using quetiapine (p=.40). Motor worsening was
noted at one point in 32% (28/87) of Parkinson's
disease and 27% (3/11) of DLB patients over the duration of quetiapine use (p=.74).
Conclusion: Long-term quetiapine use
was generally well tolerated in this geriatric Parkinson's disease and DLB population.
Mild motor worsening occurred in some patients. No significant difference in long-term efficacy
and motor worsening associated with quetiapine
treatment was noted between the 2 disorders.