DRUG-INDUCED PSYCHOSIS IN PARKINSONS-DISEASE - A REVIEW OF MANAGEMENT

Drug-induced psychosis represents one of the more serious adverse effe cts of therapy for Parkinson's disease. Risk factors include dementia, a history of psychiatric illness, advancing age, and the dose and dur ation of treatment with dopamine-enhancing agents. The pathophysiologi cal basis of drug-induced psychosis has not been established. Chronic changes in both the dopaminergic and serotonergic systems have been im plicated in producing these symptoms. Management options include the r eduction and/or elimination of medications used for symptomatic contro l of the illness. However, with the attendant risks of an unacceptable reduction in mobility and, in rare cases, life-threatening complicati ons, therapeutic alternatives an required. Treatment with atypical ant ipsychotic agents, such as clozapine and risperidone, presents such an avenue, Nonpharmacological treatments, including electroconvulsive th erapy (ECT), may also play a role in the management of these patients.