(1244) Evaluation of Safety in Patients Receiving Quetiapine And/or Pimavanserin for Parkinson Disease Related Psychosis

Objectives: Parkinson Disease is the second most common neurodegenerative disease in the world. Although Parkinson Disease is considered a movement disorder, patients experience a constellation of both motor and non-motor symptoms. One non-motor symptom that patients may experience as the disease progresses is Parkinson Disease related psychosis and dementia. Parkinson disease related psychosis may initially be managed by reducing the doses of dopaminergic medications or switching from one medication class to another with a lower incidence of causing such symptoms; however, these approaches may worsen a patient’s non-psychotic symptoms. For these reasons, patients may require treatment with antipsychotic medication. Of the available antipsychotic medications, quetiapine and clozapine were most recommended for use due to their lower binding affinity for the dopamine receptor. More recently, pimavanserin came to the market specifically approved for Parkinson Disease related psychosis. Pimavanserin has no dopaminergic activity and rather, is a selective serotonin 5-HT2-A receptor inverse agonist. The safety of monotherapy for any of these three agents has been questioned in recent years in this patient population. In clinical practice, it is not uncommon for patients to require dual therapy with quetiapine and pimavanserin. The purpose of this investigator-initiated study is to evaluate the safety of treatment with quetiapine and/or pimavanserin in patients with Parkinson Disease related psychosis. This study aims to evaluate the incidence and the severity of adverse events related to use of quetiapine and pimavanserin use in clinical practice.

Methods: This is a retrospective study of patients treated at one academic medical center. Patients included in this study are aged 18 years and older with a diagnosis of Parkinson Disease who received medication therapy with either pimavanserin and/or quetiapine between the time frame of August 2016 to June 2023 for Parkinson Disease related psychosis. The primary outcome is incidence and type of reported adverse effect from medication treatment. A subgroup analysis will compare patients treated with monotherapy of either quetiapine or pimavanserin to patients who received both agents simultaneously.

Results: There are no results yet as data is currently being collected for this project.

Conclusions: Unable to provide a conclusion yet as the data is currently being collected.