Apomorphine in Parkinson's Disease Patients With Visual Hallucinations
Parkinson's Disease, Hallucinations, Visual
About this trial
This is an interventional treatment trial for Parkinson's Disease focused on measuring Apomorphine
Eligibility Criteria
Inclusion Criteria:
- Female and male subjects aged ≥30;
- Diagnosis of established PD, defined by the Movement Disorders Society PD criteria (Postuma et al., 2015);
- Presence of visual severe hallucinations defined as more than 3 times a week (van Laar et al., 2010);
- Visual hallucinations must have developed after PD diagnosis;
- Visual hallucinations must have been optimally treated with reduction of dopamine agonists if possible, and prescription of clozapine and/or cholinesterase inhibitors if needed;
- Female subjects must complaint with a highly effective contraceptive method (oral hormonal contraception alone is not considered highly effective and must be used in combination with a barrier method) during the study, if sexually active;
- Subjects should be able and capable of adhering to the protocol, visit schedules, and medication intake according to the judgement of the investigator.
Exclusion Criteria:
- Symptomatic, clinically relevant and medically uncontrolled orthostatic hypotension;
- Patients with a prolonged QT interval corrected for heart rate according to Bazett's formula (QTc) of >450 ms for male and >470 ms for female at screening, or history of a long QT syndrome;
- PD medication change (i.e., dopamine-agonists, amantadine, monoamine oxidase (MAO)-B inhibitors, anticholinergics and cholinesterase inhibitors) in last month prior to initiation (van Laar et al., 2010);
- Active psychosis or a history of significant psychosis;
- Any medical condition that is likely to interfere with an adequate participation in the study including e.g. current diagnosis of unstable epilepsy, clinically relevant cardiac dysfunction and/or myocardial infarction or stroke within the last 12 months.
Sites / Locations
- Department of NeurologyRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Apomorphine
Placebo
This arm will be treated with continuous subcutaneous infusion of apomorphine. The infusion will start with 1 mg/hr during the waking day (approximately 16 hours). The flow rate will be adjusted on a weekly basis, and may be increased with 0.5 to 1.0 mg/hr per discretion of the investigator, aiming at the disappearance of visual hallucinations. The duration of treatment is 4 weeks.
This arm will be treated with continuous subcutaneous infusion of placebo. The infusion will start with 1 mg/hr during the waking day (approximately 16 hours). The flow rate will be adjusted on a weekly basis, and may be increased with 0.5 to 1.0 mg/hr per discretion of the investigator aiming at the disappearance of visual hallucinations. The duration of treatment is 4 weeks.