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Conference Roundup 2019 AAN Annual Meeting American Academy of Neurology Philadelphia, PA

ANXIETY, DEPRESSION LINKED TO LEVODOPARESPONSIVE FREEZING OF GAIT IN PARKINSON DISEASE Depression and anxiety are associated with levodopa-responsive freezing of gait (FOG) in patients with Parkinson disease (PD) but not with levodopaunresponsive FOG, according to research presented at the 2019 American Academy of Neurology Annual Meeting, held May 4-10, 2019, in Philadelphia, Pennsylvania. A cohort of 125 patients with PD were assessed for depression and anxiety. One of 3 FOG subtypes was determined: no freezing, levodopa-responsive freezing (RFOG), and levodopa-unresponsive freezing (URFOG).

Of the total sample, 14% of patients presented with RFOG, 11% with URFOG, and 18% with depression/ anxiety. Current depression was associated with significantly increased odds of RFOG (OR, 4.84). In a similar fashion, a marginally significant association was identified for current anxiety and RFOG (OR, 3.90). Associations between depression or anxiety and URFOG were not significant. “These results suggest that anxiety or depression may be differentially associated with [RFOG]. [URFOG] may reflect distinct underlying pathophysiology with potentially less interaction with limbic cortico-basal ganglia pathways,” the investigators concluded. Reference McKay J, Goldstein F, Factor S. Anxiety and depression are associated with levodopa-responsive, but not levodopa-unresponsive, freezing of gait in

This retrospective cohort study included 91 participants with Parkinson disease or dementia with Lewy bodies. Time to medication discontinuation constituted the primary outcome, while secondary outcomes included psychosis improvement, reason for discontinuation, and mortality. Among those taking quetiapine, 22% discontinued; among those taking pimavanserin, 33% discontinued. Significantly more participants discontinued quetiapine than pimavanserin due to side effects (70% vs 13.3%, respectively). Discontinuation due to inefficacy was more common in the pimavanserin vs quetiapine group (53.3% vs 10% respectively). Mortality rates were 15% and 7% in the quetiapine and pimavanserin groups, respectively. Hallucinations improved comparably in both the quetiapine and pimavanserin cohorts (65.2% vs 75.6%, respectively).

Parkinson’s disease. Presented at: 2019 American Academy of Neurology Annual Meeting; May 4-10;

Reference

Philadelphia, PA. Abstract P2.8-031.

Horn S, Dahodwala N. Pimavanserin versus quetiapine for the treatment of psychosis in Parkinson’s

IMAGES: TOP, BOTTOM: © GETTY IMAGES

disease and dementia with Lewy bodies. Presented

Freezing of gait may occur when individuals start to walk or need to turn.

PIMAVANSERIN AND QUETIAPINE COMPARABLE FOR PSYCHOSIS IN PARKINSON DISEASE No significant differences between pimavanserin and quetiapine in time to discontinuation, mortality, or psychosis improvement were noted among individuals with Parkinson disease or Lewy body dementia, according to research presented at AAN 2019.

16 THE CLINICAL ADVISOR • JUNE 2019 • www.ClinicalAdvisor.com

at: 2019 American Academy of Neurology Annual Meeting; Philadelphia, PA. Abstract P2.8-037.

ADVERSE EVENTS ASSOCIATED WITH LASMIDITAN FOR ACUTE MIGRAINE Lasmiditan for the treatment of acute migraine is associated with quickonset, self-limiting, mild to moderate

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