Quetiapine and ziprasidone in the treatment of the psychotic disorders in Parkinson's disease

Introduction. As neurologists we often find it necessary to use antipsychotics in our clinical practice. They are not only used in the treatment of the behavioural disorders accompanying dementias, but also in the psychotic symptoms that frequently appear or complicate the clinical progress of our patients suffering from Parkinson. Patients and methods. Taking into account the numerous side effects of the typical antipsychotic drugs, we began a prospective study on the use of a new antipsychotic agent, quetiapine, in the treatment of 134 patients with Parkinson's disease who presented signs or symptoms of parkinsonian psychosis at some time during the course of their clinical progression; results were analysed at three and six months. At the same time, we review the efficacy of another antipsychotic agent, ziprasidone, which from the chemical point of view fulfils a profile that suits the needs of our patients. At the time of writing this paper we have recorded 43 cases of patients with Parkinson's disease and concomitant parkinsonian psychoses, which responded adequately to treatment without any kind of side effects. Results. The administration of quetiapine in doses of 25-50 mg/day brought about an important improvement in the control over the signs of parkinsonian psychoses in our patients. The same occurred with the administration of 20-40 mg/day of ziprasidone. Both drugs were found to be extremely well tolerated and of great clinical value in the treatment of this clinical entity. Conclusions. Both quetiapine and ziprasidone are drugs that can be of great value in the treatment of parkinsonian psychoses. In addition to their high degree of clinical effectiveness, they also have a broad safety profile and no side effects.