The palliative role of clozapine in advanced Parkinson’s disease
Bibliographic record
Abstract
Background In Parkinson’s Disease (PD), over half of the patients develop psychotic symptoms over the course of their disease (1). PD Psychosis is associated with an increased risk of nursing home admission, and mortality when compared to patients without psychosis (2). Clozapine is recommended by NICE as an antipsychotic that does not worsen motor symptoms for patients with PDP. Results In the South Tees Movement disorder service, we looked at 33 patients that have been prescribed clozapine from 2016 until November 2023. 19 patients had died since commencing clozapine, and 14 are still currently receiving the treatment. 79% of the patients who died, started clozapine within their last 2 years of life. Average treatment length of those who died on clozapine was 18.5 months, which is slightly lower than the average length of time on clozapine for all patients at 21 months. Seven patients stopped clozapine, all of whom had died at the time of data collection. Conclusion This data indicates that within the PD service, psychosis requiring clozapine prescription often occurs within the last 2 years of life. Clozapine has a role in symptomatic relief in these patients, hence effectively improving the quality of life of advanced PD and reducing caregiver strain.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".