Journal of Alzheimers Disease & Parkinsonism
Open Access

Abstract

Psychosis occurs in over 50% and dementia in approximately 80% of persons with Parkinson�?¢�?�?�?�?s disease. Treatment with non-selective atypical and typical antipsychotics significantly increases mortality rates in Parkinson�?¢�?�?�?�?s disease; as well as other dementias. Research on the most commonly used antipsychotic in Parkinson�?¢�?�?�?�?s, quetiapine, has not revealed significant reduction in Parkinson�?¢�?�?�?�?s psychotic symptoms. Antipsychotic use, due to dopamine antagonism, is associated with unsteady gait and motor dysfunction; which exacerbates pre-existing Parkinsonian symptoms. Persons with Parkinson�?¢�?�?�?�?s disease are already at risk for falls with gait asymmetry, short strides and increased stride duration. Parkinson�?¢�?�?�?�?s patients have an increased hip fracture risk. The newly FDA-approved selective serotonin inverse agonist, pimavanserin, offers targeted treatment at the 5-HT2A receptor site responsible for Parkinson�?¢�?�?�?�?s psychosis; without affecting dopaminergic receptor binding. Research reveals a decrease in hallucinations and delusions in Parkinson�?¢�?�?�?�?s psychosis without worsening of motor symptoms. An evidencebased/ case study format will present management of Parkinson�?¢�?�?�?�?s psychosis with or without dementia, using FDA-approved treatment; as opposed to antipsychotics with full black box warnings that are commonly prescribed. Clinical outcomes, costeffectiveness, quality of life, decreased risk for emergency room visits, hospitalizations and mortality and will be discussed.

Biography

Susan Scanland is a Gerontological Nurse Practitioner and Certified Dementia Practitioner and national Alzheimer’s and Dementia Expert with 34 years of experience. She received her MSN from University of Pittsburgh and BSN from Wilkes University. She has been nationally certified as a Gerontological Nurse Practitioner since 1984 and is also a Certified Dementia Practitioner. She holds a Nursing Faculty Specialist position at the University of Scranton. She taught in geriatric faculty positions at Binghamton University (SUNY) from 1999-2004 and the Wyoming Valley Family Practice Residency in Kingston, Pennsylvania from 1987-1999. She is Founder of Dementia Connection® LLC. She is one of two nurse practitioners in the world to receive the Certified Speaking Professional award (CSP) through the National Speakers Association. She presented to geriatric psychiatrists from 15 countries at the American Association for Geriatric Psychiatry Annual Meeting in Washington DC in March 2016. She is Dementia Consultant to a long-term care facility in northeastern Pennsylvania and also provided rural nursing home consults via telehealth. She co-authored two articles on antipsychotic reduction recently in consultant pharmacist and geriatric nursing.