Low-dose olanzapine for levodopa induced dyskinesias

Neurology. 2000 Sep 26;55(6):795-9. doi: 10.1212/wnl.55.6.795.

Abstract

Objective: To assess the usefulness of low-dose olanzapine (2.5 to 7. 5 mg/day) for Levodopa-induced-dyskinesias (LID) in patients with PD.

Methods: Ten patients with PD and LID took part in this randomized, placebo-controlled, double blind, crossover trial. Patients received a 2-week course of olanzapine or placebo in each treatment phase with 1-week washout in between. Dyskinesias were assessed at baseline and after each treatment period with an acute dopaminergic challenge and unified PD rating scale (UPDRS) questionnaires. Patients also kept on/off and dyskinesia diaries for the last 3 days prior to each assessment.

Results: There was a 41% difference in dyskinesia reduction on olanzapine compared to placebo, as measured by objective dyskinesia rating scales (mean percentage reduction abnormal involuntary movement score: 30% versus -11.2%, p < 0.02). Similar differences were demonstrated by patient diaries (mean reduction: 46% versus -2%, p < 0.02) and UPDRS items 32 and 33. Compared with placebo, treatment with olanzapine resulted in significant increases in 'off' time as measured by patient diaries (30% versus 2%) and reported adverse events (1.7 versus 0.1) including increased parkinsonism (1.1 versus 0.1) and a nonsignificant reported increase in drowsiness.

Conclusions: Low-dose olanzapine is effective in reducing dyskinesias in PD, but even at very low doses can result in unacceptable increases in parkinsonism and 'off' time.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Benzodiazepines
  • Double-Blind Method
  • Dyskinesia, Drug-Induced / drug therapy*
  • Dyskinesia, Drug-Induced / physiopathology
  • Female
  • Humans
  • Levodopa / adverse effects*
  • Male
  • Middle Aged
  • Olanzapine
  • Pirenzepine / administration & dosage*
  • Pirenzepine / adverse effects
  • Pirenzepine / analogs & derivatives*

Substances

  • Benzodiazepines
  • Pirenzepine
  • Levodopa
  • Olanzapine