Psychiatry

Answer 2 Quetiapine. Quetiapine, an atypical antipsychotic, is often used as a first-line agent for the treatment of drug-induced psychosis in Parkinson’s disease;3,4 however, there has been at least 1 negative study.5 Clozapine, another atypical antipsychotic, is also effective6 but carries the risk of serious adverse effects (eg, infection, agranulocytosis); thus, quetiapine may be a better first choice. Classic or “typical” antipsychotic agents, such as haloperidol, trifluoperazine, and thiothixene, worsen the motor symptoms of Parkinson’s disease and are not recommended for the treatment of drug-induced psychosis. REFERENCES 3.  Molho ES, Factor SA. Parkinson’s disease: the treatment of drug-induced hallucinations and psychosis. Curr Neurol Neurosci Rep 2001;1:320-8. 4. Juncos JL, Roberts VJ, Evatt ML, et al. Quetiapine improves psychotic symptoms and cognition in Parkinson’s disease. Mov Disord 2004;19:29-35. 5. Ondo WG, Tintner R, Voung KD, et al. Double-blind, placebo-controlled, unforced titration parallel trial of quetiapine for dopaminergic-induced hallucinations in Parkinson’s disease. Mov Disord 2005;20:958-63. Click here to return to the questions

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