|
Neuroleptic Sensitivity in
Parkinson's Disease and Parkinsonian Dementias
Dag Aarsland, M.D., Ph.D.
Robert Perry, F.R.C.Path.
Jan P. Larsen, M.D., Ph.D.
Ian G. McKeith,
F.R.C.Psych.
John T. O'Brien, M.R.C.Psych.
Elaine K. Perry, Ph.D.
David Burn, M.D.
Clive G. Ballard, M.R.C.Psych., M.D. |
|
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
practice.
(J Clin Psychiatry
2005;66:633-637)
This entire article is available in PDF format |
|
Received Feb. 16, 2004; accepted
Nov. 16, 2004. From the Section of Geriatric Psychiatry (Dr. Aarsland)
and the Department of Neurology (Dr. Larsen), Central Hospital, Rogaland,
Stavanger, Norway; the Department of Neuropathology (Dr. Perry) and the
Department of Old Age Psychiatry (Drs. McKeith, O'Brien, Perry, and
Burn), Newcastle General Hospital, Newcastle Upon Tyne, U.K.; and
Wolfson Centre for Age-Related Diseases, King's College London, London,
Great Britain (Dr. Ballard).
The authors report no conflicts of
interest, financial disclosures, or other relationships relevant to the
subject matter of this article.
The authors would like to thank the
Medical Research Council, U.K., for supporting this study.
Corresponding author and reprints:
Clive Ballard, M.R.C.Psych., M.D., Wolfson Centre for Age-Related
Diseases, School of Biomedical Sciences, King's College London, Guy's
Campus, London, Great Britain, SE1 1UL (e-mail:clive.ballard@kcl.ac.uk). |
|