PT  - JOURNAL ARTICLE
AU  - Jacqueline M Graham
AU  - Jon D Sussman
AU  - Kay S Ford
AU  - Harvey J Sagar
TI  - Olanzapine in the treatment of hallucinosis in idiopathic parkinson’s disease: a cautionary note
AID  - 10.1136/jnnp.65.5.774
DP  - 1998 Nov 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 774--777
VI  - 65
IP  - 5
4099  - http://jnnp.bmj.com/content/65/5/774.short
4100  - http://jnnp.bmj.com/content/65/5/774.full
SO  - J Neurol Neurosurg Psychiatry1998 Nov 01; 65
AB  - BACKGROUND Hallucinosis is a dopaminergic dose limiting complication of the treatment of idiopathic Parkinson’s disease. Typical neuroleptic medications cannot be used for suppressing hallucinosis because the extrapyramidal side effects worsen parkinsonian motor control. Olanzapine is a novel atypical antipsychotic drug with few reported extrapyramidal side effects which may be more suitable for controlling hallucinosis in these patients. METHODS Olanzapine was given to five patients with idiopathic Parkinson’s disease and the dosage was titrated until a clinically meaningful reduction in hallucinosis was achieved. The commercially available 5 mg, 7.5 mg and 10 mg tablets were used. RESULTS After an initial 9 days of treatment, hallucinosis frequency was significantly reduced, an effect which was maintained with continued treatment. However, during this early phase of treatment, parkinsonian motor disability increased, which resulted in two of the patients discontinuing medication. CONCLUSIONS Olanzapine is effective in the suppression of hallucinosis in patients with idiopathic Parkinson’s disease but the currently available dose increments may result in an unacceptable exacerbation of motor disability.