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Cholinesterase inhibitors for Parkinson’s disease-related visual hallucinations unresponsive to atypical antipsychotics

Author(s): Tomasz Sobow

Journal: Archives of Medical Science
ISSN 1734-1922

Volume: 3;
Issue: 1;
Start page: 69;
Date: 2007;
Original page

Keywords: cholinesterase inhibitors | rivastigmine | donepezil | Parkinson’s disease | hallucinations | clinical trial | open label

Introduction: Considering lack of accepted guideline in cases of Parkinson’s disease-related visual hallucinations with poor response or intolerance to antipsychotics, and their possible cholinergic pathogenesis, the trial with cholinesterase inhibitors seems to be legitimated. Material and methods: Five patients with PD (with or without dementia) complicated by VH and unresponsive to atypical antipsychotics were offered a 12-week, open-label trial of a cholinesterase inhibitor. Results: All 5 subjects completed the trial with no major adverse effects and, noteworthy, no discontinuations due to adverse events. VH resolved in 4 subjects and were markedly diminished in one person. Neither changes in UPDRS scores nor exaggeration of subjective complaints about extrapyramidal symptoms were noted during treatment. Conclusions: Cholinesterase inhibitors, rivastigmine or donepezil, might represent a useful alternative to antipsychotics for patients with PD accompanied by VH even in the absence of dementia.
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