Neuroleptic Sensitivity in Parkinson's Disease and Parkinsonian Dementias
J Clin Psychiatry 2005;66(5):633-637
© Copyright 2016 Physicians Postgraduate Press, Inc.
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Background: Severe sensitivity to neuroleptic
agents is a major clinical problem in dementia with Lewy bodies
(DLB), but has not been determined in Parkinson's disease (PD)
and PD with dementia (PDD).
Method: Severe neuroleptic sensitivity reactions
(NSRs) were evaluated according to an operationalized definition
blind to clinical and neuropathologic diagnoses in prospectively
studied patients exposed to neuroleptics from 2 centers. The
study was conducted from June 1995 to May 2003.
Results: Ninety-four patients were included (15
with DLB, 36 with PDD, 26 with PD, 17 with Alzheimer's disease,
all diagnosed with various operational criteria). Severe NSR only
occurred in patients with Lewy body disease: DLB (8 [53%]), PDD
(14 [39%]), and PD (7 [27%]), but did not occur in Alzheimer's
disease (p = .006). Severe NSR was not associated with other
clinical or demographic features. In DLB, severe NSR was not
associated with neuropathologic indices (Consortium to Establish
a Registry for Alzheimer's Disease staging, Braak staging, or
cortical distribution of Lewy bodies).
Conclusions: An operationalized
evaluation of severe NSR blind to diagnosis confirmed the high
prevalence in DLB and identified high frequencies in Parkinson's
disease and PDD with important implications for clinical