The use of olanzopin in pharmacopsychoses

Pharmacologically induced psychoses must be counted among the more frequent side-effects of drugs used in the treatment of parkinson's disease (PD). U sing the usual antipsychotic neuroleptics enhances the extrapyramidal motor symptoms (EPMS) or involves the risk of provoking agranulocytosis (clozapi n). We investigated PD patients suffering from pharmacopsychosis in order t o evaluate if olanzapin, an atypical neuroleptic, was effective without inc reasing EPMS. We studied 21 PD patients suffering from visual hallucination s and paranoid symptoms. They were treated, in addition to unchanged PD med ication, with 2.5-10 mg olanzapin in incremental dosage. The result was dis appointing. Only 3 patients were without psychoses while remaining stable i n respect of PD symptoms. The other 18 intolerably suffered from EPMS, even before any antipsychotic effect was registered. In these cases olanzapin t reatment was discontinued. Therefore we conclude that olanzapin can be used in the treatment of pharmacopsychoses in PD patients only in a small minor ity of cases. In the vast majority, however, it is inferior to clozapin.