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Information about Pimavanserin

Pimavanserin is an atypical antipsychotic used in the treatment of hallucinations and psychosis in patients with Parkinson disease.

Liver safety of Pimavanserin

Use of pimavanserin is associated with a low rate of serum enzyme elevations during therapy, and it has not been linked to instances of clinically apparent acute liver injury.

Mechanism of action of Pimavanserin

Pimavanserin (pim" a van' ser in) is non-dopaminergic atypical antipsychotic agent that appears to act as a selective inverse agonist of the serotonin (5-HT) 2A receptor. It has little or no activity against the 5-HT2B and 2C receptors which may account for its relative lack of adverse effects. The absence of dopamine receptor activity suggested that pimavanserin would be appropriate for patients with Parkinson disease psychosis which is usually resistant to the atypical antipsychotic medications and can be worsened by inhibition of dopaminergic transmission.

FDA approval information for Pimavanserin

Clinical studies demonstrated its effectiveness in Parkinson disease psychosis and it was approved for this use in the United States in 2016. Pimavanserin is available in tablets of 17 mg under the brand name Nuplazid.

Dosage and administration for Pimavanserin

The typical dose is 34 mg once daily.

Side effects of Pimavanserin

Common side effects include somnolence, headache, confusion, hallucinations, and peripheral edema. Rare, but potentially serious adverse events include prolongation of the QT interval and increased risk of death in elderly patients with dementia related psychosis.

Antipsychotic agents

First Generation

Second Generation (Atypicals)

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