Therapy of behavioral disorders in Parkinson's disease

Behavioral disturbances in Parkinson's disease (PD) are a common source of disability to both patients and their families, but there is a considerable controversy regarding their frequency and their neuropathological and neur ochemical bases. Since they are so common, the disorders associated with PD should be well recognized, and proper management by neurologists is requir ed. The most frequent behavioral disturbances encountered in patients with PD are depression, anxiety, cognitive impairment and dementia. Also frequen t are sleep disorders such as sleep fragmentation, REM sleep behavior disor der, insomnia and altered dreaming. The most troublesome situations come fr om drug-induced psychiatric states, such as delusional stares, hallucinatio ns, paranoid ideation, delirium, and confusion. The treatment of these beha viors is reviewed here. (C) 1999 Elsevier, Paris.