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Half of Parkinson's Patients With Psychosis Use Antipsychotics

Despite FDA warnings, no change in overall antipsychotic use in Parkinson's from 2002 to 2008

WEDNESDAY, July 13 (HealthDay News) -- The overall use of antipsychotics in Parkinson's disease (PD) remained unchanged from the 2002 fiscal year (FY) to the 2008 FY, with 50 percent of patients with PD and psychosis (PDP) prescribed an antipsychotic in routine clinical care in the 2008 FY, according to a study published in the July issue of the Archives of Neurology.

Daniel Weintraub, M.D., from the University of Pennsylvania in Philadelphia, and colleagues investigated the frequency and characteristics of antipsychotic use, including changes over time, in patients with PD. Rates and predictors of antipsychotic prescribing patterns were obtained from the Veterans Affairs database, and compared between 2,597 individuals with PDP and 6,907 individuals with dementia and psychosis without PD. Data were compared from the 2002 and 2008 FYs, to determine changes over time in antipsychotic prescribing patterns.

The investigators found that 50 percent of patients with PDP were prescribed an antipsychotic in the 2008 FY, with the atypical antipsychotic quetiapine prescribed in 66 percent of the patients, high potency antipsychotics prescribed in 30 percent, and clozapine prescribed rarely. The use of antipsychotics in PD remained unchanged from the 2002 to 2008 FYs, with a decrease in use of risperidone and olanzapine compensated by an increase in quetiapine use and the introduction of aripiprazole.

"We found that half of patients with PDP are prescribed an antipsychotic in routine clinical care, most commonly an atypical antipsychotic," the authors write. "Despite 2005 and 2008 U.S. Food and Drug Administration warnings regarding associations between antipsychotic use and mortality in patients with dementia, a common comorbid condition in PD, overall antipsychotic use in PD was unchanged between FY 2002 and FY 2008."

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