Medicine and Health Sciences | Open Access Articles

Guidance For Switching From Off-Label Antipsychotics To Pimavanserin For Parkinson’S Disease Psychosis: An Expert Consensus, Kevin J. Black, Henry Nasrallah, Stuart Isaacson, Mark Stacy, Rajesh Pahwa, Charles H. Adler, Gustavo Alva, Jeffrey W. Cooney, Daniel Kremens, Matthew A. Menza, Jonathan M. Meyer, Ashwin A. Patkar, Tanya Simuni, Debbi A. Morrissette, Stephen Stahl

Kevin J. Black, MD

Patients with Parkinson’s disease psychosis (PDP) are often treated with an atypical antipsychotic, especially quetiapine or clozapine, but side effects, lack of sufficient efficacy, or both may motivate a switch to pimavanserin, the first medication approved for management of PDP. How best to implement a switch to pimavanserin has not been clear, as there are no controlled trials or case series in the literature to provide guidance. An abrupt switch may interrupt partially effective treatment or potentially trigger rebound effects from antipsychotic withdrawal, whereas cross-taper involves potential drug interactions. A panel of experts drew from published data, their experience treating …

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Neurobiology Of The Premonitory Urge In Tourette’S Syndrome: Pathophysiology And Treatment Implications, Andrea E. Cavanna, Kevin J. Black, Mark Hallett, Valerie Voon

Kevin J. Black, MD

Motor and vocal tics are relatively common motor manifestations identified as the core features of Tourette’s syndrome (TS). Although traditional descriptions have focused on objective phenomenological observations, such as anatomical location, number and frequency of tics, patients’ first-person accounts have consistently reported characteristic subjective correlates. These sensory phenomena are often described as a feeling of mounting inner tension or urge to move (“premonitory urge”), which is transiently relieved by tic expression. This article reviews the existing literature on the clinical and neurobiological aspects of the premonitory urge in patients with TS, with focus on its pathophysiology and possible treatment implications.

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A New Treatment For Psychosis In Parkinson’S Disease, Kevin J. Black

Kevin J. Black, MD

This is an update on treatment of hallucinations and delusions in Parkinson disease, including the recently approved Nuplazid™ (pimavanserin).

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Brain Structure In Pediatric Tourette Syndrome, Alton C. Williams, Kevin J. Black

Kevin J. Black, MD

Previous studies of brain structure in Tourette syndrome (TS) have produced mixed results, and most had modest sample sizes. In the present multi-center study, we used structural MRI to compare 103 children and adolescents with TS to a well-matched group of 103 children without tics. We applied voxel-based morphometry methods to test gray matter (GM) and white matter (WM) volume differences between diagnostic groups, accounting for MRI scanner and sequence, age, sex and total GM + WM volume. The TS group demonstrated greater GM volume in posterior thalamus, hypothalamus and midbrain, and lower WM volume bilaterally in orbital and medial …

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Parkinson’S Disease Psychosis: A Roundtable Discussion, Jennifer G. Goldman, Rajesh Pahwa, Stuart H. Isaacson, Kevin J. Black

Kevin J. Black, MD

A discussion about diagnosing and managing Parkinson's disease psychosis, with 3 neurologists and a neuropsychiatrist, all from movement disorders centers. Supplement to Clinical Neurology News. Disclosure: supplement was supported by ACADIA Pharmaceuticals.

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A Pilot Study Of Basal Ganglia And Thalamus Structure By High Dimensional Mapping In Children With Tourette Syndrome, Alton C. Williams, Marie E. Mcneely, Deanna J. Greene, Jessica A. Church, Stacie L. Warren, Johanna M. Hartlein, Bradley L. Schlaggar, Kevin J. Black, Lei Wang

Kevin J. Black, MD

No abstract provided.

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Depression In Parkinson Disease, Kevin J. Black

Kevin J. Black, MD

Many patients with Parkinson disease develop depressive symptoms severe enough to discuss with their physician. Below I will address some of the questions we hear from patients and families about depression in Parkinson disease.

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Towards Objectively Quantifying Sensory Hypersensitivity: A Pilot Study Of The “Ariana Effect.”, Vassilis N. Panagopoulos, Deanna J. Greene, Meghan C. Campbell, Kevin J. Black

Kevin J. Black, MD

Background. Normally one habituates rapidly to steady, faint sensations. People with sensory hypersensitivity (SH), by contrast, continue to attend to such stimuli and find them noxious. SH is common in Tourette syndrome (TS) and autism, and methods to quantify SH may lead to better understanding of these disorders. In an attempt to objectively quantify SH severity, the authors tested whether a choice reaction time (CRT) task was a sensitive enough measure to detect significant distraction from a steady tactile stimulus, and to detect significantly greater distraction in subjects with more severe SH.

Methods. Nineteen ambulatory adult volunteers with varying scores …

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A Fixed-Dose Randomized Controlled Trial Of Olanzapine For Psychosis In Parkinson Disease, Michelle J. Nichols, Johanna M. Hartlein, Meredith Ga Eicken, Brad A. Racette, Kevin J. Black

Kevin J. Black, MD

Background: Psychosis is a common and debilitating side effect of long-term dopaminergic treatment of Parkinson disease (PD). While clozapine is an effective treatment, the need for blood monitoring has limited its first-line use.

Objective: Since olanzapine shows similar receptor affinity to clozapine, we hypothesized that it might be an effective alternative to clozapine for treatment of drug-induced psychosis (DIP) in PD, and that lower doses than usual might make it tolerable.

Methods: In 1998-2003 we conducted a four-week, double-blind, placebo-controlled, parallel group, fixed-dose trial of olanzapine (0, 2.5mg, or 5mg) in 23 PD patients with DIP while allowing for clinically …

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Hallucinations—Psychosis Related To Parkinson’S Disease, Kevin J. Black

Kevin J. Black, MD

No abstract provided.

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Depression In Pd, Kevin J. Black

Kevin J. Black, MD

No abstract provided.

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Full-Text Articles in Medicine and Health Sciences

Kevin J. Black, MD

Neurobiology Of The Premonitory Urge In Tourette’S Syndrome: Pathophysiology And Treatment Implications, Andrea E. Cavanna, Kevin J. Black, Mark Hallett, Valerie Voon

Kevin J. Black, MD

A New Treatment For Psychosis In Parkinson’S Disease, Kevin J. Black

Kevin J. Black, MD

Brain Structure In Pediatric Tourette Syndrome, Alton C. Williams, Kevin J. Black

Kevin J. Black, MD

Parkinson’S Disease Psychosis: A Roundtable Discussion, Jennifer G. Goldman, Rajesh Pahwa, Stuart H. Isaacson, Kevin J. Black

Kevin J. Black, MD

A Pilot Study Of Basal Ganglia And Thalamus Structure By High Dimensional Mapping In Children With Tourette Syndrome, Alton C. Williams, Marie E. Mcneely, Deanna J. Greene, Jessica A. Church, Stacie L. Warren, Johanna M. Hartlein, Bradley L. Schlaggar, Kevin J. Black, Lei Wang

Kevin J. Black, MD

Depression In Parkinson Disease, Kevin J. Black

Kevin J. Black, MD

Towards Objectively Quantifying Sensory Hypersensitivity: A Pilot Study Of The “Ariana Effect.”, Vassilis N. Panagopoulos, Deanna J. Greene, Meghan C. Campbell, Kevin J. Black

Kevin J. Black, MD

A Fixed-Dose Randomized Controlled Trial Of Olanzapine For Psychosis In Parkinson Disease, Michelle J. Nichols, Johanna M. Hartlein, Meredith Ga Eicken, Brad A. Racette, Kevin J. Black

Kevin J. Black, MD

Hallucinations—Psychosis Related To Parkinson’S Disease, Kevin J. Black

Kevin J. Black, MD

Depression In Pd, Kevin J. Black

Kevin J. Black, MD