Increased use of antipsychotics in Parkinson's patients before onset of disease

Recent research has revealed that patients having Parkinson's disease use antipsychotics even before the diagnosis to relieve the symptoms. Further Psychotic symptoms occur years before the motor symptoms and are challenging to recognize as prodromal symptoms since they cannot be clinically associated with the diagnosis of PD. 

The study  was published in the journal Parkinsonism and related disorders. 

Antipsychotic use is common among people having Parkinson's disease. Past literature assessed the use of antipsychotic drugs after Parkinson's disease (PD) diagnosis but not before the diagnosis. Hence, researchers conducted a study to find the incidence of antipsychotic drug use among community-dwelling persons with and without PD a decade before and after the PD diagnosis.  

Using the nationwide register-based FINPARK study 20,994 persons with PD diagnosed between 1996–2015 were included in the study. 142,944 who had not used antipsychotics during a one-year washout before the follow-up was also taken into the study as comparison persons. PD was diagnosed according to the United Kingdom's Parkinson's disease Society Brain Bank's criteria. Antipsychotic initiations in six-month time windows were assessed. 

Key findings: 

Results

• 26.9% (n = 5,654) of people with PD initiated antipsychotics in comparison to 9.7% (n = 13,887) of people without PD during the entire follow-up.
• Approximately four years before the PD diagnosis the incidence of drug usage increased in people with PD.
• The most commonly initiated antipsychotic was quetiapine (n = 3,642, 64.4%) in persons with PD and risperidone (n = 5,232, 37.7%) in comparison persons.
• The initiation rates were higher in persons with PD before and after the index date.  

Thus, the researchers concluded that persons with PD have symptoms treated with antipsychotics both before and after diagnosis. 

Take home points: 

The use of antipsychotic medications is substantially more common among people with Parkinson's disease than in the general population, according to a new study based on national data in Finland.

Results show that the increase in antipsychotic use among Parkinson's patients is evident several years before the disease is diagnosed. 

To read the full article, click here:  https://doi.org/10.1016/j.parkreldis.2022.08.024 

Lilja S, Tolppanen AM, Koponen M, Hartikainen S, Tiihonen M. Incidence of antipsychotic use among community dwellers with and without Parkinson's disease [published online ahead of print, 2022 Aug 24]. Parkinsonism Relat Disord. 2022;103:69-72.