Trial reportMovement disorders : official journal of the Movement Disorder Society2018
Pimavanserin for Parkinson's Disease psychosis: Effects stratified by baseline cognition and use of cognitive-enhancing medications.
Trial report in Movement disorders : official journal of the Movement Disorder Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Systematic Review on Parkinson's Disease Medications, Emphasizing on Three Recently Approved Drugs to Control Parkinson's Symptoms.International journal of environmental research and public health · 2021Pooled it
- New Antipsychotic Medications in the Last Decade.Current psychiatry reports · 2021Pooled it
- A Review of the Recent Advances in the Pharmacological Management of Parkinson's Disease.Cureus · 2025Review
- Lewy body dementia: exploring biomarkers and pathogenic interactions of amyloid β, tau, and α-synuclein.Molecular neurodegeneration · 2025Review
- Emerging Pharmacological Approaches for Psychosis and Agitation in Alzheimer's Disease.CNS drugs · 2025Review
- Novel and experimental therapeutics for the management of motor and non-motor Parkinsonian symptoms.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Review
- Global research trends and hotspots in Parkinson's disease psychosis: a 25-year bibliometric and visual analysis.Frontiers in aging neuroscience · 2024Article
- Future Directions for Developing Non-dopaminergic Strategies for the Treatment of Parkinson's Disease.Current neuropharmacology · 2024Review
- Ulotaront, a Trace Amine-Associated Receptor 1/Serotonin 5-HTNeurology. Clinical practice · 2023Article
- The future of psychopharmacology: a critical appraisal of ongoing phase 2/3 trials, and of some current trends aiming to de-risk trial programmes of novel agents.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2023Article
- An Update on Nondopaminergic Treatments for Motor and Non-motor Symptoms of Parkinson's Disease.Current neuropharmacology · 2023Review
- Advances in the Pharmacological and Non-pharmacological Management of Non-motor Symptoms in Parkinson's Disease: An Update Since 2017.Current neuropharmacology · 2023Review
- Emerging role of psychosis in Parkinson's disease: From clinical relevance to molecular mechanisms.World journal of psychiatry · 2022Review
- Motor- and cognition-related safety of pimavanserin in patients with Parkinson's disease psychosis.Frontiers in neurology · 2022Article
- Relevance of 5-HTCNS drugs · 2021Review
- Management of psychiatric disorders in Parkinson's disease : Neurotherapeutics - Movement Disorders Therapeutics.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2020Review
- Hallucinations in Parkinson's disease: new insights into mechanisms and treatments.Advances in clinical neuroscience & rehabilitation : ACNR · 2020Article
- The Neuropsychiatry of Parkinson Disease: A Perfect Storm.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2019Review
- Aberrant resting-state oscillatory brain activity in Parkinson's disease patients with visual hallucinations: An MEG source-space study.NeuroImage. Clinical · 2019Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundPD psychosis is often associated with cognitive impairment, including dementia, and involves dopaminergic, serotonergic, and cholinergic mechanisms.
objectiveTo evaluate the differential effect of the antipsychotic pimavanserin, a selective serotonin 2A receptor inverse agonist, in PD psychosis patients with versus without cognitive impairment and in those receiving versus not receiving cognitive-enhancing medications.
methodsData from the pivotal randomized clinical trial of pimavanserin for PD psychosis were stratified by (1) screening MMSE score as cognitively impaired (21-24) versus unimpaired (≥25) and (2) concomitant use versus nonuse of cognitive-enhancing medications. The primary outcome measure was change in the PD-adapted Scale for the Assessment of Positive Symptoms.
resultsMean (pimavanserin vs. placebo) change from baseline was larger in the cognitively impaired (n = 50; -6.62 vs. -0.91; P = 0.002) versus the cognitively unimpaired (n = 135; -5.50 vs. -3.23; p = 0.046) group. The comparable change was -6.04 versus -2.18 (P = 0.012) and -5.66 versus -3.15 (P = 0.041) in patients treated (n = 69) and not treated (n = 116) with concomitant cognitive-enhancing medication. Pimavanserin was similarly tolerated across all cognitive groups with no additional safety concerns identified. Overall adverse event rates were comparable across the concomitant cognitive-enhancing medication groups; however, rates of serious adverse events and discontinuations attributed to adverse events were increased in patients taking cholinesterase inhibitors.
conclusionsThe antipsychotic effect of pimavanserin is robust in PD patients with cognitive impairment and may be enhanced by concomitant cognitive-enhancing medication use. Future prospective studies are needed to confirm these preliminary findings. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.