Nuplazid (pimavanserin)

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Nuplazid (pimavanserin)

Manufacturer Acadia Pharmaceuticals Inc.
Disease Parkinson's Disease
Indication Hallucinations and delusions associated with Parkinson’s disease psychosis
Mode of Action Atypical antipsychotic
Approval Status FDA approved (USA)
Strength 17 mg

Who is pimavanserin for?

Nuplazid (pimavanserin) is indicated for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis [1].

Recommended dose

Complete information about Nuplazid (pimavanserin) dosage and administration can be found here [1].
The standard dosage is:
  • 34 mg, taken orally as two 17 mg tablets once daily [1].
Consult your treating doctor for personalised dosing.

What is pimavanserin and how does it work?

Nuplazid (pimavanserin) is the first medicine approved for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis [2].
Hallucinations or delusions can occur in as many as 50 % of patients with Parkinson’s disease at some time during the course of their illness. People who experience them see or hear things that are not there (hallucinations) and/or have false beliefs (delusions). The hallucinations and delusions experienced with Parkinson’s disease are serious symptoms which can lead to impaired thoughts and emotions that may be disturbing and disabling. As a result, patients may not relate to loved ones well or take appropriate care of themselves [2]. The mechanism of action of pimavanserin in the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis is unknown. However, its effect could be mediated through a combination of inverse agonist and antagonist activity at serotonin receptors [1], which influence various biological and neurological processes such as aggression, anxiety, appetite, cognition, learning, memory, mood, nausea, sleep, and thermoregulation [3].

What is pimavanserin's approval status?

Nuplazid (pimavanserin) was approved by:
  • FDA (USA) on April 29, 2016
for the treatment of patients with hallucinations and delusions associated with Parkinson’s disease psychosis [2].
The approval was based on a 6-week clinical trial involving 199 participants. In this study, pimavanserin was shown to be superior to placebo in decreasing the frequency and/or severity of hallucinations and delusions without worsening the primary motor symptoms of Parkinson’s disease [2].
As with other atypical antipsychotic drugs, there is an increased risk of death associated with the use of these drugs to treat older people with dementia-related psychosis. No drug in this class is approved to treat patients with dementia-related psychosis  [2].
In clinical trials, the most common side effects reported by participants were: swelling, usually of the ankles, legs, and feet due to the accumulation of excessive fluid in the tissue (peripheral edema); nausea; and abnormal state of mind (confused state) [2].
References
[1] Summary of Product Characteristics [FDA]: Nuplazid (pimavanserin), Acadia Pharmaceuticals Inc., Apr. 2016.
http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/207318lbl.pdf
[2] FDA News Release: FDA approves first drug to treat hallucinations and delusions associated with Parkinson’s disease, 29/04/2016.
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm498442.htm
[3] Wikipedia. 5-HT receptor. (last update: 22/08/2017), cited on 23/08/2017.
https://en.wikipedia.org/wiki/5-HT_receptor

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Medicine information contained herein may be time sensitive. The absence of a warning for a given medicine or combination thereof in no way should be construed to indicate that the medicine or combination is safe, effective or appropriate for any given patient. Always consult your treating physician before starting a course of treatment.

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