PSYCHOSIS IN PARKINSONS-DISEASE - DIAGNOSIS AND TREATMENT

1. This article reviews the prevalence, diagnosis, pathophysiology and management of psychosis in Parkinson's disease. 2. Psychosis in Parki nson's disease has been associated with all antiparkinsonian medicatio ns. The most common symptoms are vivid disturbing dreams, visual hallu cinations and paranoid delusions. 3. The emergence of psychosis reduce s the patient's functional capacity and increases caregiver burden. It also poses a therapeutic dilemma because effective treatment of psych otic symptoms may result in worsening of motor symptoms and vice versa . 4. Increased physician awareness is essential for proper diagnosis a nd management. Withdrawal of anticholinergic medications and amantadin e followed by levodopa dose adjustment is effective in many patients. 5. Atypical neuroleptics, in low doses, may be successful when other m easures have failed. However, these agents are not approved for treati ng Parkinsonian psychosis and must be considered as investigational th erapies.