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Neuroleptic sensitivity in Parkinson's disease and parkinsonian dementias

Lookup NU author(s): Dr Dag Aarsland, Emeritus Professor Robert Perry, Professor Ian McKeith, Professor John O'Brien, Emeritus Professor Elaine Perry, Professor David Burn, Dr Clive Ballard

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Abstract

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.


Publication metadata

Author(s): Aarsland D, Perry R, Larsen JP, McKeith IG, O'Brien JT, Perry EK, Burn D, Ballard CG

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Psychiatry

Year: 2005

Volume: 66

Issue: 5

Pages: 633-637

ISSN (print): 0160-6689

ISSN (electronic): 1555-2101

Publisher: Physicians Postgraduate Press

URL: http://dx.doi.org/10.4088/JCP.v66n0514

DOI: 10.4088/JCP.v66n0514


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