Pimavanserin and Dementia-Related Psychosis

Pimavanserin is primarily an oral 5HT_2A inverse agonist and antagonist approved to treat psychosis in patients with Parkinson disease (PD) that may also treat dementia-related psychosis. In this randomized, double-blind, placebo-controlled, manufacturer-sponsored, phase 3 clinical trial, researchers investigated the effect of pimavanserin on psychosis due to dementia associated with PD, Alzheimer disease (AD), vascular disease (VaD), or frontotemporal dementia (FTD). Participants were included if they had psychosis for at least 2 months and a care partner who could reliably report patient symptoms. After a 12-week open-label phase, patients who responded at 8 and 12 weeks were randomized to either continue pimavanserin or switch to a placeb…