Pimavanserin: Relief from psychosis in dementia, without devastating side-effects

February 13, 2018, University of Exeter
Clive Ballard, Professor of Age-Related Diseases, University of Exeter Medical School. Credit: University of Exeter

A new kind of antipsychotic has been found to relieve terrifying and disturbing symptoms suffered by millions of people with Alzheimer's disease worldwide.

New research led by the University of Exeter Medical School, and published today in Lancet Neurology found that pimavanserin significantly improves in with the condition, without the devastating side-effects of currently-used antipsychotics. The research found an even greater benefit in those with the most severe psychotic symptoms.

Up to half of the 45 million people worldwide who are living with Alzheimer's will experience psychotic episodes, a figure that is even higher in some other forms of dementia. Psychosis is linked to a faster deterioration in dementia.

Currently there is no approved safe and effective treatment for these distressing symptoms. In people with dementia, widely-used antipsychotics lead to sedation, falls and can double the speed at which brain function deteriorates. Their use increases risk of falls, and leads to 1,660 unnecessary strokes and 1,800 unnecessary deaths in the UK every year. Despite all of these negative effects they have very little benefit in improving psychosis in people with dementia Pimavanserin works differently to other antipsychotics, by blocking a very specific nerve receptor (THT2A) in the brain. Now, it has been found to effectively reduce symptoms of psychosis in people with Alzheimer's disease without the damaging effects of other antipsychotics.

Clive Ballard, Professor of Age-Related Diseases at the University of Exeter Medical School, who led the research, said: "Psychosis is a particularly terrifying symptom of Alzheimer's disease. People may experience paranoia, or see, hear or smell things that are not there. It's distressing both for those experiencing the delusions and for their carers.

"It's particularly encouraging that most benefit was seen in those with the most severe psychotic , as this group is most likely to be prescribed antipsychotics. We are talking about vulnerable elderly, frail people who are suffering terrifying symptoms, being sedated with current antipsychotics even though its well known that they cause terrible health issues and even death in people with dementia, and have very little benefit. We urgently need to do better by them, and our encouraging results provides hope. We're delighted that our results have led to a larger phase 3 clinical trial which is now ongoing." The findings are the result of a double-blind, placebo-controlled exploratory trial designed to evaluate the efficacy and safety of pimavanserin in 181 patients with Alzheimer's disease psychosis, with 90 of them given pimavanserin and 90 of them on a placebo. Its safety and efficacy in reducing psychotic symptoms in dementia is now being assessed in a larger-scale clinical trial in the US.

The results build on previous research that found pimavanserin was effective for people with dementia related to Parkinson's disease. Pimavanserin has been approved for use by the Food and Drug Administration (FDA) in the US for this purpose, but has not yet been submitted for approval to the European equivalent, the European Medicines Agency.

Previously, the Alzheimer's Society said it is "imperative" that it goes through European approval processes for Parkinson's Disease Dementia.

Pimavanserin is currently the subject of a Phase III trial In the US to assess its safety in a wider group, and to see if it can prevent relapse of in some of the most common forms of .

The paper, Evaluation of the efficacy, tolerability, and safety of pimavanserin versus placebo in patients with Alzheimer's disease and : phase 2, randomised, placebo-controlled, double blind study, is published today in Lancet Neurology.

Explore further: Psychosis in Parkinson's dementia—new treatment provides hope

Related Stories

Psychosis in Parkinson's dementia—new treatment provides hope

September 25, 2017
New research involving King's College London and the University of Exeter has highlighted the benefits of a promising new treatment which could relieve psychosis in thousands of people with dementia related to Parkinson's ...

Global experts seek to end damaging dementia psychosis cycle

October 2, 2017
A new research report calls for a change in approach in the treatment of psychosis in dementia, to find alternatives to highly damaging antipsychotics.

New drug could offer first safe and effective treatment for psychotic symptoms

October 31, 2013
Up to 10 million people worldwide have Parkinson's disease and more than 50 percent of them will experience psychosis (mainly hallucinations and delusions) at some time. Pimavanserin, a new non-dopaminergic drug, may offer ...

Antipsychotics increase risk of death in people with Parkinson's disease psychosis

September 30, 2015
Antipsychotic drugs may increase the risk of death in people with Parkinson's disease psychosis (PDP), according to a new study led by researchers from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's ...

Alzheimer's drug targeting soluble amyloid falls short in a large clinical trial

January 25, 2018
A paper published today in the New England Journal of Medicine reports that solanezumab, a monoclonal antibody-based treatment for Alzheimer's disease developed by Eli Lilly that targets amyloid plaques, did not significantly ...

An ingredient in cannabis may be useful for treating psychosis – new study

December 15, 2017
Psychiatric patients treated with a substance found in cannabis, cannabidiol, showed a significant reduction in psychotic symptoms and were also more likely to be rated as "improved" by their psychiatrist, our latest study ...

Recommended for you

To sleep, perchance to forget

February 17, 2018
The debate in sleep science has gone on for a generation. People and other animals sicken and die if they are deprived of sleep, but why is sleep so essential?

Newborn babies who suffered stroke regain language function in opposite side of brain

February 17, 2018
It's not rare that a baby experiences a stroke around the time it is born. Birth is hard on the brain, as is the change in blood circulation from the mother to the neonate. At least 1 in 4,000 babies are affected shortly ...

Lab-grown human cerebellar cells yield clues to autism

February 16, 2018
Increasing evidence has linked autism spectrum disorder (ASD) with dysfunction of the brain's cerebellum, but the details have been unclear. In a new study, researchers at Boston Children's Hospital used stem cell technology ...

Fragile X syndrome neurons can be restored, study shows

February 16, 2018
Fragile X syndrome is the most frequent cause of intellectual disability in males, affecting one out of every 3,600 boys born. The syndrome can also cause autistic traits, such as social and communication deficits, as well ...

Brain-machine interface study suggests how brains prepare for action

February 16, 2018
Somewhere right now in Pyeongchang, South Korea, an Olympic skier is thinking through the twists and spins she'll make in the aerial competition, a speed skater is visualizing how he'll sneak past a competitor on the inside ...

Humans blink strategically in response to environmental demands

February 16, 2018
If a brief event in our surroundings is about to happen, it is probably better not to blink during that moment. A team of researchers at the Centre for Cognitive Science from Technische Universität Darmstadt published a ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.