CLOZAPINE USE IN PARKINSONS-DISEASE - A RETROSPECTIVE ANALYSIS OF A LARGE MULTICENTERED CLINICAL-EXPERIENCE

We conducted a multicentered, retrospective review of clozapine's (CZP ) effects on a range of psychiatric, sleep, cognitive, motor, and sens ory disorders in Parkinson's disease (PD). Therapeutic outcomes and ad verse events were compared with varying prescribing practices at parti cipating sites. The medical records of 172 consecutive PD patients tre ated with CZP at four movement disorder clinics were reviewed. Low-dos e CZP improved psychiatric symptoms of psychosis, anxiety, depression, hypersexuality, sleep disturbance, and akathisia. Tremor, torticollis , limb dystonia, and pain showed modest rates of improvement. Twenty-t hree percent of patients withdrew as a result of adverse events or tre atment failure. Inpatient CZP initiation did not improve therapeutic e fficacy, or reduce adverse events or the withdrawal rate. Low-dose CZP in the outpatient setting is generally an effective and well-tolerate d treatment for many of the psychiatric, sleep, motor, and sensory dis turbances common to late-stage PD.