Parkinson’s disease is a disorder with a multitude of symptoms including movement difficulties such as shaking and difficulty walking; and mental symptoms such as paranoia and hallucinations. The later can be just as debilitating as the former.
In one case study, recorded by Brain, a journal of Neurology, a 71-year-old woman with Parkinson’s, who lived in Paris, had the vivid sensation that her sister, who lived elsewhere in the city, was lying in bed beside her. She would lift the top sheet of her bed to check that her sister was not there, and once had a visual hallucination that two people were in her bedroom.
In a second case, a 71-year-old man saw “small incorporeal devils with a blurred face and changing size” that moved rapidly in a haze. He thought the devils were “butchering” his back with knives. Eventually he came to tolerate the devils, and reported the sensation of living in a fantasy novel. He was aware the demons were not real, but would talk to them occasionally.
Hallucinations like this are common among Parkinson’s patients. One study estimated that one-third of all Parkinson’s sufferers have visual hallucinations, but that three-quarters would have them at some point over a 20-year period.
Drugs to treat those symptoms have been slow to arrive. Pimavanserin, developed by Acadia Pharmaceuticals, is the first product that the FDA has approved to treat the disorder, and it also happens to be one of the few new psychiatric drugs of any kind to be released in recent years.
The drug offers a new clinical option to hundreds of thousands of people, but Acadia believes that America’s 1 million or so Parkinson’s patients are only the beginning. That’s why Acadia, headquartered in San Diego, has opened a new clinical research and development office in Carnegie Center.
“Our company is growing, and with that expansion, we decided to open an East Coast location with the intention to be in an area where we have better access to experienced talent for our business,” said Serge Stankovic, executive vice president and head of research and development for Acadia. “The Princeton area is full of biopharmaceutical companies with a lot of talent that we can pull.”
The staff of the office, which opened in April, will work on studying potential applications for Pimavanserin (marketed as Nuplazid). Clinical trials are under way for the drug treating agitation and psychosis in Alzheimer’s disease, schizophrenia that hasn’t responded to existing drugs, and certain symptoms of schizophrenia such as emotional withdrawal, loss of interest, lack of motivation, and difficulty thinking. It’s also being tested for major depressive disorder patients who have not gotten better with other drugs.
Nuplazid differs from other antipsychotic drugs in a crucial way that makes it suitable for treating Parkinson’s disease. In Parkinson’s patients, neurons in the brain that control movement become impaired and die, causing the brain to produce less dopamine, a critical neurotransmitter that helps regulate movement and is related to experiencing pleasure.
Unfortunately, existing antipsychotic drugs work by blocking dopamine receptors, so taking them would only worsen the symptoms of Parkinson’s. But Pimavanserin works differently, instead blocking the receptors of serotonin, a neurotransmitter that regulates mood, without affecting dopamine.
“Uniqueness in selective pharmacology makes Pimavanserin a good choice for treatment of Parkinson’s disease psychosis,” Stankovic says, “but also has an opportunity in a number of other diseases because of that.”
Acadia’s Carnegie Center office currently has about 30 people working on these new applications, and there are six open positions.
Stankovic, who leads the new office, grew up in Serbia, where his mother was an educational administrator and his father worked for a benefit fund. “I was always interested in research in a medical field,” Stankovic said. “That was the reason that, after my medical training, I took training in epidemiology to better understand research methodology, particularly clinical research.”
He earned a medical degree at the University of Belgrade and a master’s in epidemiology at the University of Alabama at Birmingham. Before joining Acadia in 2015, he was an executive at Teva Pharmaceuticals, Forest Laboratories, and Neurogen Corporation.
“Coordinating clinical trials was essentially a calling that I always enjoyed doing and wanted to do,” he says. “I have experienced working for very large companies and for small and mid-size companies, and I enjoy the entrepreneurial spirit of smaller companies such as Acadia, where there is always the opportunity to be in the front line of research efforts.”
Stankovic has high hopes for the success of the new drug, and for its future applications. “I’m very excited to be part of this community, and very excited to be working on central nervous systems disorders with significant medical need.”