Psychosis and Parkinson's Disease

Christina L. Vaughan, Jennifer G Goldman*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

The clinical spectrum of Parkinson's disease (PD) psychosis ranges from mild illusions to formed hallucinations or even frank delusions. Hallucinations occur in about one-third of PD patients treated with chronic dopaminergic therapy and are most often visual. Delusions are less common but typically consist of wellsystematized, thematic ideas such as paranoia or in fidelity. PD psychosis may be due to extrinsic (i.e., pharmacological treatment) and/or intrinsic (i.e., diseaserelated) factors. Risk factors for the development of psychosis include older age; advanced disease; akinetic-rigid motor phenotype; concomitant cognitive impairment, depression, or sleep disturbances; and multiple medical problems. When psychosis in PD develops acutely, becomes troublesome or frightening, or poses a safety risk, medical attention is necessary. Medical management of acute psychosis typically includes the following: identifying and addressing specific causes (e.g., infection, medications), reducing or discontinuing medications for PD and other conditions that may aggravate psychosis, and introducing antipsychotic medications. Since antipsychotics with dopamine-blocking properties may worsen parkinsonism, medications with greater serotonergic properties such as clozapine and quetiapine are favored. Effective and well-studied treatments that improve PD psychosis without worsening motor function are still needed.

Original languageEnglish (US)
Title of host publicationMovement Disorder Emergencies
Subtitle of host publicationDiagnosis and Treatment: Second Edition
PublisherHumana Press Inc
Pages75-92
Number of pages18
ISBN (Electronic)9781607618355
ISBN (Print)9781607618348
DOIs
StatePublished - Jan 1 2013

ASJC Scopus subject areas

  • Medicine(all)

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