Pimavanserin
Parkinson Disease, Hallucinations
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Drug Status
Government Approvals
US(FDA)
WHO Essential Medicine
NO
Known Teratogen
No
Pharmaceutical Class
Atypical Antipsychotic
Controlled Drug Substance
No
Pimavanserin
Summary
Pimavanserin is used to treat hallucinations and delusions in people with Parkinson's disease psychosis. This is a condition where Parkinson's disease, a disorder of the nervous system, causes symptoms such as seeing things that aren't there or believing things that aren't true.
Pimavanserin works by changing the activity of certain natural substances in the brain. It acts as an inverse agonist and antagonist at serotonin 5-HT2A receptors. This action helps reduce the symptoms of psychosis such as hallucinations and delusions associated with Parkinson's disease.
The usual daily dose of Pimavanserin for adults is 34 mg taken orally once daily. You can take this medication with or without food. There is no established dose for children as its safety and effectiveness have not been established in pediatric patients.
Common side effects of Pimavanserin include nausea, constipation, peripheral edema (swelling), and confusional state. Serious adverse effects can include hallucinations, difficulty walking, rash, hives, swelling of the face or throat, and shortness of breath. If any serious side effects occur, seek immediate medical attention.
Elderly patients with dementia-related psychosis treated with Pimavanserin are at an increased risk of death. Also, it should not be used with other drugs that prolong the QT interval as this can increase the risk of serious heart problems. It is contraindicated in patients with a history of hypersensitivity to the drug or its components.
Indications and Purpose
How does Pimavanserin work?
Pimavanserin acts as an inverse agonist and antagonist at serotonin 5-HT2A receptors, with a lesser effect on 5-HT2C receptors. This action helps to modulate the activity of serotonin in the brain, reducing hallucinations and delusions associated with Parkinson's disease psychosis.
Is Pimavanserin effective?
The efficacy of Pimavanserin in treating hallucinations and delusions associated with Parkinson's disease psychosis was demonstrated in a 6-week, randomized, placebo-controlled study. Patients taking Pimavanserin showed a statistically significant improvement in symptoms compared to those taking a placebo, as measured by the SAPS-PD scale.
What is Pimavanserin?
Pimavanserin is used to treat hallucinations and delusions in people with Parkinson's disease psychosis. It works by altering the activity of certain natural substances in the brain, particularly through its action on serotonin receptors. This helps reduce the severity and frequency of psychotic symptoms.
Directions for Use
For how long do I take Pimavanserin?
Pimavanserin is typically used for long-term treatment, especially in managing hallucinations and delusions associated with Parkinson's disease psychosis. The duration of use should be determined by a healthcare provider based on individual patient needs and response to treatment.
How do I take Pimavanserin?
Pimavanserin should be taken once daily, with or without food, at the same time each day. There are no specific food restrictions while taking this medication. However, always follow your doctor's instructions and consult them if you have any concerns about your diet while on Pimavanserin.
How long does it take for Pimavanserin to start working?
Pimavanserin may take several weeks to show its full effects. Patients should continue taking the medication as prescribed and consult their healthcare provider if they have concerns about its effectiveness or experience any side effects.
How should I store Pimavanserin?
Store Pimavanserin at room temperature, between 20°C to 25°C (68°F to 77°F), away from excess heat and moisture. Protect the capsules from light and keep them in their original container, tightly closed, and out of reach of children.
What is the usual dose of Pimavanserin?
The usual daily dose of Pimavanserin for adults is 34 mg taken orally once daily. There is no established dose for children as the safety and effectiveness of Pimavanserin have not been established in pediatric patients.
Warnings and Precautions
Can I take Pimavanserin with other prescription drugs?
Pimavanserin should not be used with strong CYP3A4 inducers, as they can reduce its effectiveness. When used with strong CYP3A4 inhibitors, the dose of Pimavanserin should be reduced. Additionally, avoid using Pimavanserin with other drugs that prolong the QT interval to prevent increased risk of cardiac arrhythmias.
Can Pimavanserin be taken safely while breastfeeding?
There is no information on the presence of Pimavanserin in human milk or its effects on the breastfed infant. The benefits of breastfeeding should be weighed against the mother's need for Pimavanserin and any potential adverse effects on the infant. Consult your healthcare provider for personalized advice.
Can Pimavanserin be taken safely while pregnant?
There are no adequate data on the use of Pimavanserin in pregnant women to assess the risk of major congenital malformations or miscarriage. Animal studies have not shown adverse developmental effects at doses up to 10-12 times the human dose. Pregnant women should discuss the potential risks and benefits with their healthcare provider.
Is Pimavanserin safe for the elderly?
Elderly patients with dementia-related psychosis treated with antipsychotic drugs, including Pimavanserin, are at an increased risk of death. Pimavanserin is not approved for treating dementia-related psychosis unless related to Parkinson's disease. It is crucial for elderly patients to be closely monitored by their healthcare provider while on this medication.
Who should avoid taking Pimavanserin?
Pimavanserin is contraindicated in patients with a history of hypersensitivity to the drug. It should not be used in patients with dementia-related psychosis unrelated to Parkinson's disease due to increased mortality risk. Additionally, Pimavanserin prolongs the QT interval, so it should be avoided in patients with known QT prolongation or those taking other QT-prolonging drugs.
