Pimavanserin vs. Quetiapine for Treatment of Parkinson's Psychosis

PHASE4RecruitingINTERVENTIONAL
Enrollment

358

Participants

Timeline

Start Date

October 24, 2022

Primary Completion Date

October 24, 2026

Study Completion Date

August 24, 2027

Conditions
Parkinson's Disease Psychosis
Interventions
DRUG

Pimavanserin

Fixed-dose Pimavanserin - Pimavanserin is a new antipsychotic agent, and pure 5HT-2A inverse agonist, that was approved by the FDA recently (2016) for the treatment of PDP. It is the only FDA-approved medication for PDP, but is still not the first-line AP used in PD. All participants assigned to pimavanserin will receive the FDA-approved dose of 34 mg (equivalent to 40 mg pimavanserin tartrate) daily without titration up or down; however, because pimavanserin is blinded to quetiapine, participants will undergo sham titration based on tolerability (i.e., overall adverse event profile) and efficacy (i.e., improvement in severity of psychosis).

DRUG

Quetiapine

"Flexible-dose Quetiapine - Quetiapine, which is a mixed serotonin and dopamine receptor antagonist, is by far the most commonly used AP for PDP. However, scientific evidence for the efficacy of quetiapine in PDP is almost non-existent as most of the studies were underpowered, had high drop-out rates, and possibly underdosed quetiapine. Quetiapine immediate and extended release will be titrated as shown:~Baseline visit Quetiapine: 25 mg IR QHS, All participants must be up-titrated to 50 mg/day~Week 1 call Quetiapine: 50 mg XR QHS, Up-titration to 50 mg~Week 3 visit Quetiapine: 100 mg XR QHS, Up-titration as appropriate~Week 5 visit Quetiapine: 150 mg XR QHS, Up- or down-titration as appropriate~Week 6 call Quetiapine: 200 mg XR QHS, Up- or down-titration as appropriate"

Trial Locations (24)

19106

RECRUITING

Philadelphia MultiService Center, Philadelphia, PA, Philadelphia

44106

RECRUITING

Louis Stokes VA Medical Center, Cleveland, OH, Cleveland

55417

RECRUITING

Minneapolis VA Health Care System, Minneapolis, MN, Minneapolis

77030

RECRUITING

Michael E. DeBakey VA Medical Center, Houston, TX, Houston

80045

RECRUITING

Rocky Mountain Regional VA Medical Center, Aurora, CO, Aurora

97239

RECRUITING

VA Portland Health Care System, Portland, OR, Portland

85723-0001

TERMINATED

Southern Arizona VA Health Care System, Tucson, AZ, Tucson

92357-1000

RECRUITING

VA Loma Linda Healthcare System, Loma Linda, CA, Loma Linda

94304-1207

RECRUITING

VA Palo Alto Health Care System, Palo Alto, CA, Palo Alto

94121-1563

ACTIVE_NOT_RECRUITING

San Francisco VA Medical Center, San Francisco, CA, San Francisco

90073-1003

TERMINATED

VA Greater Los Angeles Healthcare System, West Los Angeles, CA, West Los Angeles

32608-1135

ACTIVE_NOT_RECRUITING

North Florida/South Georgia Veterans Health System, Gainesville, FL, Gainesville

60141-3030

ACTIVE_NOT_RECRUITING

Edward Hines Jr. VA Hospital, Hines, IL, Hines

40502-2235

TERMINATED

Lexington VA Medical Center, Lexington, KY, Lexington

48105-2303

ACTIVE_NOT_RECRUITING

VA Ann Arbor Healthcare System, Ann Arbor, MI, Ann Arbor

63106-1621

ACTIVE_NOT_RECRUITING

St. Louis VA Medical Center John Cochran Division, St. Louis, MO, St Louis

87108-5153

TERMINATED

New Mexico VA Health Care System, Albuquerque, NM, Albuquerque

13210-2716

TERMINATED

Syracuse VA Medical Center, Syracuse, NY, Syracuse

28805-2576

TERMINATED

Asheville VA Medical Center, Asheville, NC, Asheville

19104-4551

RECRUITING

Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, Philadelphia

37212-2637

TERMINATED

Tennessee Valley Healthcare System Nashville Campus, Nashville, TN, Nashville

78229-4404

TERMINATED

South Texas Health Care System, San Antonio, TX, San Antonio

23249-0001

TERMINATED

Hunter Holmes McGuire VA Medical Center, Richmond, VA, Richmond

98108-1532

ACTIVE_NOT_RECRUITING

VA Puget Sound Health Care System Seattle Division, Seattle, WA, Seattle

All Listed Sponsors
lead

VA Office of Research and Development

FED