Low dose of clozapine in the treatment of dopaminergic psychosis in Parkinson's disease

被引:41
作者
Ruggieri, S
DePandis, MF
Bonamartini, A
Vacca, L
Stocchi, F
机构
[1] UNIV ROMA LA SAPIENZA,DEPT NEUROSCI,I-00185 ROME,ITALY
[2] MEDITERRANEAN INST NEUROSCI NEUROMED,I-86077 POZZUOLO FRIULI,ITALY
关键词
clozapine; Parkinson's disease; dopaminergic psychosis;
D O I
10.1097/00002826-199706000-00003
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Dopaminerpic psychosis frequently complicates the pharmacological treatment of Parkinson's disease. Dose reduction of dopaminomimetic therapy or treatment with conventional neuroleptics improves psychosis but worsens parkinsonism. In an open-label 12-month trial, the clinical antipsychotic efficacy of the atypical neuroleptic clozapine was investigated in 36 parkinsonian patients (age range 46-85 years) with symptoms of dopaminergic psychosis including delusions, vivid dreams, hallucinations, frank paranoid delirium, and hypersexuality. Clozapine, given orally at bedtime, was started at a dose of 6.25 mg and titrated upward to the minimal effective dose. In all patients. psychosis responded to very low clozapine doses (mean 10.59 +/- 6.48 mg/day). Clozapine doses correlated with the severity of psychosis. During clozapine treatment, parkinsonian disabilities and levodopa dosage remained statistically unchanged. During the 12-month study, no patient had clozapine-induced agranulocytosis or other severe side effects. These findings indicate that even at low doses, clozapine effectively controls dopaminergic psychosis in Parkinson's disease patients without compromising motor function.
引用
收藏
页码:204 / 209
页数:6
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