Behavioural Neurology

Behavioural Neurology / 2013 / Article
Special Issue

Relationships Among Cognitive, Behavioral and Psychiatric Symptoms in Parkinson’s Disease

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Review | Open Access

Volume 27 |Article ID 645429 | https://doi.org/10.3233/BEN-129016

J. H. Friedman, "Parkinson Disease Psychosis: Update", Behavioural Neurology, vol. 27, Article ID 645429, 9 pages, 2013. https://doi.org/10.3233/BEN-129016

Parkinson Disease Psychosis: Update

Received23 Nov 2012
Accepted23 Nov 2012

Abstract

Psychotic symptoms are common in drug treated patients with Parkinson's disease (PD). Visual hallucinations occur in about 30% and delusions, typically paranoid in nature, occur in about 5%. These problems, particularly the delusions, cause great distress for patient and caregivers, and are among the most important precipitants for nursing home placement. Psychotic symptoms carry a poor prognosis. They often herald dementia, and are associated with increased mortality. These symptoms often abate with medication reductions, but this may not be tolerated due to worsened motor function. Only clozapine has level A evidence to support its use in PD patients with psychosis (PDP), whether demented or not. While quetiapine has been recommended by the American Academy of Neurology for “consideration,” double blind placebo controlled trials have demonstrated safety but not efficacy. Other antipsychotic drugs have been reported to worsen motor function and data on the effectiveness of cholinesterase inhibitors is limited. PDP remains a serious problem with limited treatment options.

Copyright © 2013 Hindawi Publishing Corporation and the authors. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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