ArticlePloS one2023
Assessing the risks of treatment in Parkinson disease psychosis: An in-depth analysis.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Pimavanserin safety in adult and elderly patients with neuropsychiatric symptoms related to neurodegenerative disease: An open-label extension study.Journal of Alzheimer's disease : JAD · 2025Trial
- Safety Profile of Pimavanserin Therapy in Elderly Patients with Neurodegenerative Disease-Related Neuropsychiatric Symptoms: A Phase 3B Study.Journal of Alzheimer's disease : JAD · 2024Trial
- Real-world evidence of pimavanserin utilization among patients with Parkinson's disease psychosis: a review of real-world data that augments data from randomized controlled trials.Journal of comparative effectiveness research · 2025Review
- Exploring the risk of adverse drug events in combination with antiparkinsonics and antipsychotics-a two-decade real-world pharmacovigilance analysis based on the FAERS database.The international journal of neuropsychopharmacology · 2025Article
- Establishing a robust triangulation framework to explore the relationship between hearing loss and Parkinson's disease.NPJ Parkinson's disease · 2025Article
- Parkinson disease psychosis: from phenomenology to neurobiological mechanisms.Nature reviews. Neurology · 2024Review
- Retrospective analyses evaluating the mortality risk associated with pimavanserin or other atypical antipsychotics in patients with Parkinson disease psychosis.Clinical parkinsonism & related disorders · 2024Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundParkinson disease (PD) psychosis (PDP) is a disabling non-motor symptom. Pharmacologic treatment is limited to pimavanserin, quetiapine, and clozapine, which do not worsen parkinsonism. A Food and Drug Administration black box warning exists for antipsychotics, suggesting increased mortality in elderly patients with dementia. However, the reasons for higher mortality are unknown.
aimExpanding on prior work exploring mortality in treated PDP patients, we conducted a retrospective comparison to understand the links between treatment regimen, clinical characteristics, and negative outcomes.
methodsElectronic medical record data extraction included clinically diagnosed PD patients between 4/29/16-4/29/19 and excluded patients with primary psychiatric diagnoses or atypical parkinsonism. Mortality and clinical characteristics during the study period were compared between untreated patients and those receiving pimavanserin, quetiapine, or both agents (combination). Mortality analyses were adjusted for age, sex, levodopa equivalent daily dose (LEDD), and dementia.
resultsThe pimavanserin group (n = 34) had lower mortality than the untreated group (n = 66) (odds ratio = 0.171, 95% confidence interval: 0.025-0.676, p = 0.026). The untreated group had similar mortality compared to the quetiapine (n = 147) and combination (n = 68) groups. All treated groups had a higher LEDD compared to the untreated group, but no other differences in demographics, hospitalizations, medical comorbidities, medications, or laboratory values were found between the untreated and treated groups.
conclusionsPDP patients receiving pimavanserin had lower mortality than untreated patients. We found no other clear differences in clinical characteristics to explain the mortality risk. Prospective randomized trials are needed to definitively identify the optimal PDP treatment regimen and associated risks.
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