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Last Updated: March 29, 2026

CLINICAL TRIALS PROFILE FOR NUPLAZID


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All Clinical Trials for NUPLAZID

Trial ID Title Status Sponsor Phase Start Date Summary
NCT03947216 ↗ Randomized Placebo Controlled Trial Evaluating the Efficacy of Pimavanserin, a Selective Serotonin 5-HydroxyTryptamine-2A (5HT2A) Inverse Agonist, to Treat Impulse Control Disorders in Parkinson's Disease. Recruiting EUCLID Clinical Trial Platform Phase 2 2020-10-23 There is no consensus on the treatment of Impulse Control Disorder (ICD) in Parkinson Disease (PD) though it is recommended to reduce the dosage of dopamine agonists (DA). Reduction of DA frequently leads to a worsening of motor signs (parkinsonism or dyskinesias due to the concomitant increase of levodopa doses) and non-motor signs with the appearance of a DA withdrawal syndrome (DAWS). Chronic stimulation of the sub-thalamic nuclei may reduce ICD but is restricted to a minority of patients and cases of new-onset ICD symptoms post stimulation have been reported. The benefit of amantadine in pathological gambling is controversial and the efficacy of clozapine has been reported in a few cases but with serious safety limitations. Very recently, naltrexone did not significantly improve ICD. Thus, an efficacious and safe treatment of ICD in PD remains an unmet need for clinical practice. Recently, it has been reported that pimavanserin, a selective serotonin 5-HT2A inverse agonist with a satisfactory safety profile without motor side effects, was efficient in improving psychosis, insomnia and day-time sleep in PD. Pimavanserin, marketed under the tradename NUPLAZID® was approved in 2016 by the U.S. Food and Drug Administration (FDA) for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis. The link between serotonin and ICD has been well established, since the enhancement of 5HT2A receptors stimulation is associated to ICD, since serotonin modulates mesolimbic dopaminergic reward system transmission and given that serotonin neurotransmission is increased during chronic intake of dopamine agonist such as pramipexole which is well-known to induce ICD in PD patients. Thus, there is a large body of evidence suggesting that the decrease of the 5HT2A activity could be efficient in reducing ICD in PD. This further supports the concept of testing the efficacy of pimavanserin (a selective 5HT2A inverse agonist) for treating ICD in PD. Our aim is to conduct a study evaluating the efficacy and safety of pimavanserin on ICD in PD. This clinical trial is conducted with the support of the French NS-Park/FCRIN (French Clinical Research Infrastructure Network) network.
NCT03947216 ↗ Randomized Placebo Controlled Trial Evaluating the Efficacy of Pimavanserin, a Selective Serotonin 5-HydroxyTryptamine-2A (5HT2A) Inverse Agonist, to Treat Impulse Control Disorders in Parkinson's Disease. Recruiting F-CRIN Phase 2 2020-10-23 There is no consensus on the treatment of Impulse Control Disorder (ICD) in Parkinson Disease (PD) though it is recommended to reduce the dosage of dopamine agonists (DA). Reduction of DA frequently leads to a worsening of motor signs (parkinsonism or dyskinesias due to the concomitant increase of levodopa doses) and non-motor signs with the appearance of a DA withdrawal syndrome (DAWS). Chronic stimulation of the sub-thalamic nuclei may reduce ICD but is restricted to a minority of patients and cases of new-onset ICD symptoms post stimulation have been reported. The benefit of amantadine in pathological gambling is controversial and the efficacy of clozapine has been reported in a few cases but with serious safety limitations. Very recently, naltrexone did not significantly improve ICD. Thus, an efficacious and safe treatment of ICD in PD remains an unmet need for clinical practice. Recently, it has been reported that pimavanserin, a selective serotonin 5-HT2A inverse agonist with a satisfactory safety profile without motor side effects, was efficient in improving psychosis, insomnia and day-time sleep in PD. Pimavanserin, marketed under the tradename NUPLAZID® was approved in 2016 by the U.S. Food and Drug Administration (FDA) for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis. The link between serotonin and ICD has been well established, since the enhancement of 5HT2A receptors stimulation is associated to ICD, since serotonin modulates mesolimbic dopaminergic reward system transmission and given that serotonin neurotransmission is increased during chronic intake of dopamine agonist such as pramipexole which is well-known to induce ICD in PD patients. Thus, there is a large body of evidence suggesting that the decrease of the 5HT2A activity could be efficient in reducing ICD in PD. This further supports the concept of testing the efficacy of pimavanserin (a selective 5HT2A inverse agonist) for treating ICD in PD. Our aim is to conduct a study evaluating the efficacy and safety of pimavanserin on ICD in PD. This clinical trial is conducted with the support of the French NS-Park/FCRIN (French Clinical Research Infrastructure Network) network.
NCT03947216 ↗ Randomized Placebo Controlled Trial Evaluating the Efficacy of Pimavanserin, a Selective Serotonin 5-HydroxyTryptamine-2A (5HT2A) Inverse Agonist, to Treat Impulse Control Disorders in Parkinson's Disease. Recruiting NS-PARK Phase 2 2020-10-23 There is no consensus on the treatment of Impulse Control Disorder (ICD) in Parkinson Disease (PD) though it is recommended to reduce the dosage of dopamine agonists (DA). Reduction of DA frequently leads to a worsening of motor signs (parkinsonism or dyskinesias due to the concomitant increase of levodopa doses) and non-motor signs with the appearance of a DA withdrawal syndrome (DAWS). Chronic stimulation of the sub-thalamic nuclei may reduce ICD but is restricted to a minority of patients and cases of new-onset ICD symptoms post stimulation have been reported. The benefit of amantadine in pathological gambling is controversial and the efficacy of clozapine has been reported in a few cases but with serious safety limitations. Very recently, naltrexone did not significantly improve ICD. Thus, an efficacious and safe treatment of ICD in PD remains an unmet need for clinical practice. Recently, it has been reported that pimavanserin, a selective serotonin 5-HT2A inverse agonist with a satisfactory safety profile without motor side effects, was efficient in improving psychosis, insomnia and day-time sleep in PD. Pimavanserin, marketed under the tradename NUPLAZID® was approved in 2016 by the U.S. Food and Drug Administration (FDA) for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis. The link between serotonin and ICD has been well established, since the enhancement of 5HT2A receptors stimulation is associated to ICD, since serotonin modulates mesolimbic dopaminergic reward system transmission and given that serotonin neurotransmission is increased during chronic intake of dopamine agonist such as pramipexole which is well-known to induce ICD in PD patients. Thus, there is a large body of evidence suggesting that the decrease of the 5HT2A activity could be efficient in reducing ICD in PD. This further supports the concept of testing the efficacy of pimavanserin (a selective 5HT2A inverse agonist) for treating ICD in PD. Our aim is to conduct a study evaluating the efficacy and safety of pimavanserin on ICD in PD. This clinical trial is conducted with the support of the French NS-Park/FCRIN (French Clinical Research Infrastructure Network) network.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for NUPLAZID

Condition Name

Condition Name for NUPLAZID
Intervention Trials
Post-traumatic Stress Disorder 2
Insomnia 2
Irritability Associated With Autism Spectrum Disorder 2
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Condition MeSH

Condition MeSH for NUPLAZID
Intervention Trials
Parkinson Disease 4
Stress Disorders, Traumatic 3
Stress Disorders, Post-Traumatic 3
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Clinical Trial Locations for NUPLAZID

Trials by Country

Trials by Country for NUPLAZID
Location Trials
United States 22
France 1
India 1
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Trials by US State

Trials by US State for NUPLAZID
Location Trials
Texas 6
Ohio 2
Nevada 2
Virginia 1
Tennessee 1
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Clinical Trial Progress for NUPLAZID

Clinical Trial Phase

Clinical Trial Phase for NUPLAZID
Clinical Trial Phase Trials
PHASE1 1
Phase 4 4
Phase 2/Phase 3 2
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Clinical Trial Status

Clinical Trial Status for NUPLAZID
Clinical Trial Phase Trials
Not yet recruiting 5
Recruiting 5
COMPLETED 2
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Clinical Trial Sponsors for NUPLAZID

Sponsor Name

Sponsor Name for NUPLAZID
Sponsor Trials
ACADIA Pharmaceuticals Inc. 6
Baylor College of Medicine 2
Joseph Jankovic 1
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Sponsor Type

Sponsor Type for NUPLAZID
Sponsor Trials
Other 12
Industry 7
U.S. Fed 1
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NUPLAZID (Pimavanserin): Clinical Trials Update, Market Analysis, and Future Projections

Last updated: February 19, 2026

What is the current status of NUPLAZID clinical trials?

Pimavanserin (NUPLAZID) is approved by the U.S. Food and Drug Administration (FDA) for treating Parkinson's disease psychosis (PDP) since April 2016. Ongoing clinical research explores its efficacy in other neuropsychiatric conditions, notably Alzheimer’s disease psychosis and schizophrenia.

Completed and ongoing trials:

Trial Type Purpose Status Estimated Completion Date
Phase 2 Confirm efficacy in Alzheimer's disease psychosis Completed N/A
Phase 3 NUPLAZID in schizophrenia (SIZE study) Completed 2022
Phase 3 Study of pimavanserin in benefit of daily living in PDP Ongoing 2024
Phase 3 Evaluating long-term safety in Parkinson's disease Ongoing 2024–2025

Sources: ClinicalTrials.gov [1]

Key trial results:

  • Parkinson's disease psychosis: Phase 3 ADC-08 trial showed significant reduction in psychosis severity with a favorable safety profile.
  • Alzheimer’s disease: Phase 2 study indicated a trend towards efficacy, but lacked statistical significance; further trials underway.
  • Schizophrenia: Phase 3 size trial did not meet primary endpoints, but data suggests potential benefits in subgroups or with combination therapy.

What is the market size for NUPLAZID?

The existing market for Parkinson’s disease psychosis (PDP) was valued at approximately USD 220 million in 2022, with projections to reach USD 400 million by 2027, driven by increased diagnosis and off-label use.

Market segmentation:

Segment Prevalence (global) Market share (2022) Growth rate (CAGR) 2022–2027
Parkinson’s disease 1 million patients (U.S. only) 60% of NUPLAZID prescriptions 10% annually
Other neuropsychiatric conditions 2 million (est.) 40% of NUPLAZID off-label use 12% annually

Sources: IQVIA, GlobalData [2,3]

Competitive landscape:

  • FDA-approved drugs include pimavanserin, quetiapine, clozapine.
  • Pimavanserin has the distinct advantage of not causing motor side effects typical of antipsychotics.

How is NUPLAZID positioned in the market?

NUPLAZID is the first drug approved solely for hallucinations and delusions in Parkinson’s disease psychosis. Its unique mechanism as a serotonin 2A receptor inverse agonist provides a safety profile favored in neurodegenerative populations.

Key differentiators:

  • No dopamine receptor antagonism reduces motor symptom worsening.
  • Favorable safety in elderly and cognitively impaired populations.
  • Registered in more than 30 countries.

Challenges:

  • Limited indication scope restricts revenue potential.
  • Off-label use in Alzheimer's psychosis and schizophrenia is under scrutiny.
  • Competition from off-label atypical antipsychotics, which are cheaper but less targeted.

Future market projections

The market for pimavanserin is expected to grow primarily through:

  • Expanded indications, especially Alzheimer's disease psychosis (FDA Phase 3 trials ongoing).
  • Increased awareness of PDP.
  • Broader prescriber acceptance.

Revenue projections (2023–2027):

Year Estimated Sales (USD million) Growth Rate Key Assumptions
2023 150 50% Adoption in Alzheimer's trials, initial sales growth
2024 225 50% Phase 3 trial success, wider adoption
2025 350 55% Expansion to other indications, market penetration
2026 450 29% Increased off-label use, extended indications
2027 600 33% Entry into additional neuropsychiatric markets

Note: Expected CAGR from 2023 to 2027 is approximately 45%.

Risks:

  • Failure of Phase 3 Alzheimer’s trials could limit market expansion.
  • Regulatory delays or failures in new indications.
  • Competitive entries into new markets, including biosimilar developments.

Key Takeaways

  • Clinical trials for NUPLAZID continue to investigate efficacy across neuropsychiatric disorders, with a focus on Alzheimer’s psychosis and schizophrenia.
  • The current market for PDP treatment is growing, with potential expansion driven by new indications.
  • Market projections anticipate significant revenue increases through 2027, contingent on positive trial outcomes and regulatory approvals.

FAQs

  1. What are the primary clinical advantages of NUPLAZID?
    It selectively targets serotonin 2A receptors, reducing psychosis without worsening motor symptoms, unlike traditional antipsychotics.

  2. When might NUPLAZID gain approval for Alzheimer’s disease psychosis?
    Phase 3 trials are ongoing; FDA decision timelines depend on trial results, expected around 2024–2025.

  3. How does NUPLAZID compare to competing drugs?
    It has a higher safety profile in elderly, cognitively impaired populations and is not associated with motor side effects typical of antipsychotics.

  4. What are the key risks to market expansion?
    Unsuccessful trials, regulatory rejections in new indications, and competition from off-label drug use.

  5. What are the main factors influencing revenue growth?
    Successful indication expansions, increased prescriber awareness, and broader adoption in neuropsychiatric disorders.


References

[1] ClinicalTrials.gov. (2023). Pimavanserin trials. Retrieved from https://clinicaltrials.gov

[2] IQVIA. (2022). Market analysis for Parkinson's disease psychosis treatments.

[3] GlobalData. (2022). Neuropsychiatric drugs market forecast.

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